Mortality-related electrocardiogram indices in methanol toxicity

doi:10.5847/wjem.j.1920-8642.2022.032

World Journal of Emergency Medicine ›› 2022, Vol. 13 ›› Issue (3): 226-228.doi: 10.5847/wjem.j.1920-8642.2022.032

• Research Letters • Previous Articles Next Articles

Mortality-related electrocardiogram indices in methanol toxicity

Mohammad Hossein Nikoo¹, Alireza Estedal², Maryam Pakfetrat³, Firoozeh Abtahi⁴, Seyed Taghi Heydari²()

¹Non-communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz 71345-1877, Iran
²Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz 71345-1877, Iran
³Department of Internal Medicine, Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz 71345-1877, Iran
⁴Departement of Cardiology, Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz 71345-1877, Iran

Received:2021-06-06 Accepted:2021-10-26 Online:2022-05-13 Published:2022-05-01
Contact: Seyed Taghi Heydari E-mail:heydari.st@gmail.com

Abstract

Mohammad Hossein Nikoo, Alireza Estedal, Maryam Pakfetrat, Firoozeh Abtahi, Seyed Taghi Heydari. Mortality-related electrocardiogram indices in methanol toxicity[J]. World Journal of Emergency Medicine, 2022, 13(3): 226-228.

Figures/Tables 1

Table 1.

Association between death, ECG variables and acidosis evaluation in methanol toxicity with univariate and multiple logistic regression, n (%)

Varameters	Outcome		P-value	Odds ratio (95% CI) Univariate	P value	Odds ratio (95% CI) Multiple**	P-value
Varameters	Live	Dead	P-value	Odds ratio (95% CI) Univariate	P value	Odds ratio (95% CI) Multiple**	P-value
Corrected QT
<500 ms	246 (88.2)	33 (11.8)	<0.001	1	-	1	-
≥500 ms	43 (64.2)	24 (35.8)	<0.001	4.16 (2.24-7.72)	<0.001	1.81 (0.78-4.21)	0.165
QT dispersion
<40 ms	160 (87.9)	22 (12.1)	0.022	1	-	1	-
≥40 ms	130 (78.8)	35 (21.2)	0.022	1.96 (1.10-3.50)	0.023	1.85 (0.811-4.20)	0.144
T slope
<69°	197 (86.0)	32 (14.0)	0.072	1	-	1	-
≥70°	95 (78.5)	26 (21.5)	0.072	1.69 (0.95-2.99)	0.074	3.42 (1.36-8.61)	0.009
Atrioventricular conduction block
No	286 (85.4)	49 (14.6)	<0.001	1	-	1	-
Yes	4 (36.4)	7 (63.6)	<0.001	10.21 (2.88-36.20)	<0.001	4.55 (1.47-14.07)	0.120
Heart rate
60-100 beats/min	214 (86.3)	34 (13.7)	0.058	1	-	1	-
<59 beats/min	8 (66.7)	4 (33.3)		3.15 (0.90-11.02)	0.073	2.20 (0.16-29.46)	0.553
>100 beats/min	68 (78.2)	19 (21.8)		1.76 (0.94-3.28)	0.076	1.76 (0.76-4.09)	0.188
Brugada pattern
No	279 (85.3)	48 (14.7)	<0.001	1	-	1	-
Yes	11 (55.0)	9 (45.0)	<0.001	4.76 (1.87-12.09)	0.001	5.65 (1.55-20.56)	0.009
J-point elevation
No	95 (92.2)	8 (7.9)	0.002	1	-	1	-
Yes	192 (79.2)	49 (20.3)	0.002	2.98 (1.36-6.55)	0.007	2.14 (0.70-6.56)	0.185
ST-segment elevation myocardial infarction
No	280 (85.4)	48 (14.6)	<0.001	1	-	1	-
Yes	10 (52.6)	9 (47.4)	<0.001	5.25 (2.03-13.59)	0.001	3.66 (0.77-17.41)	0.103
Bundle branch block
No	270 (84.6)	49 (15.4)	0.042	1	-	1	-
Yes	18 (69.3)	8 (30.7)	0.042	2.45 (1.01-5.94)	0.048	2.31 (0.66-8.05)	0.189
Osborn wave
No	283 (84.5)	52 (15.5)	0.016	1	-	1	-
Yes	7 (58.3)	5 (41.7)	0.016	3.89 (1.12-12.72)	0.025	4.38 (0.71-27.07)	0.112
Notch QRS
No	189 (84.0)	36 (16.0)	0.746	1	-	1	-
Yes	97 (82.2)	21 (17.8)	0.746	1.10 (0.61-1.99)	0.746	0.92 (0.40-2.12)	0.843
Poor R-wave progression
No	270 (84.4)	50 (15.4)	0.109	1	-	1	-
Yes	18 (72.0)	7 (28.0)	0.109	2.10 (0.83-5.29)	0.115	1.65 (0.44-6.14)	0.459
Low QRS voltage
No	279 (84.3)	52 (15.7)	0.063	1	-	1	-
Yes	9 (64.3)	5 (35.7)	0.063	2.98 (0.96-9.25)	0.059	6.70 (1.17-38.29)	0.032
Metabolic acidosis (pH)
<7.2	133 (71.9)	52 (28.1)	<0.001	1	-	1	-
≥7.2	155 (96.9)	5 (3.1)	<0.001	12.12 (4.70-31.23)	<0.001	4.55 (1.47-14.07)	0.009
Lack of hyperventilation with severe acidosis
No	197 (94.7)	11 (5.3)	<0.001	1	-	1	-
Yes	91 (66.4)	46 (33.6)	<0.001	9.50 (4.48-18.29)	<0.001	5.74 (2.29-14.38)	<0.001

Table 1.

References 16

1	Iranpour P, Firoozi H, Haseli S. Methanol poisoning emerging as the result of COVID-19 outbreak; radiologic perspective. Acad Radiol. 2020; 27(5):755-6. doi: S1076-6332(20)30174-4 pmid: 32273134
2	Shokoohi M, Nasiri N, Sharifi H, Baral S, Stranges S. A syndemic of COVID-19 and methanol poisoning in Iran: time for Iran to consider alcohol use as a public health challenge? Alcohol. 2020; 87:25-7. doi: S0741-8329(20)30239-1 pmid: 32505493
3	Williams GF, Hatch FJ, Bradley MC. Methanol poisoning: a review and case study of four patients from central Australia. Aust Crit Care. 1997; 10(4):113-8. pmid: 9708069
4	Chang ST, Wang YT, Hou YC, Wang IK, Hong HH, Weng CH, et al. Acute kidney injury and the risk of mortality in patients with methanol intoxication. BMC Nephrol. 2019; 20(1):205. doi: 10.1186/s12882-019-1404-0
5	Jaff Z, McIntyre WF, Yazdan-Ashoori P, Baranchuk A. Impact of methanol intoxication on the human electrocardiogram. Cardiol J. 2014; 21(2):170-5. doi: 10.5603/CJ.a2013.0053
6	Nikoo MH, Arjangzadeh A, Pakfetrat M, Boogar SS, Mohammadkarimi V, Ostovan VR, et al. Electrocardiographic findings of methanol toxicity: a cross-sectional study of 356 cases in Iran. BMC Cardiovasc Disord. 2020; 20(1):415. doi: 10.1186/s12872-020-01691-y
7	Paasma R, Hovda KE, Hassanian-Moghaddam H, Brahmi N, Afshari R, Sandvik L, et al. Risk factors related to poor outcome after methanol poisoning and the relation between outcome and antidotes--a multicenter study. Clin Toxicol (Phila). 2012; 50(9):823-31. doi: 10.3109/15563650.2012.728224
8	Albert MS, Dell RB, Winters RW. Quantitative displacement of acid-base equilibrium in metabolic acidosis. Ann Intern Med. 1967; 66(2):312-22. pmid: 6016545
9	Wilson RF, Spencer AR, Tyburski JG, Dolman H, Zimmerman LH. Bicarbonate therapy in severely acidotic trauma patients increases mortality. J Trauma Acute Care Surg. 2013; 74(1):45-50. doi: 10.1097/TA.0b013e3182788fc4
10	Monterrubio-Villar J, Llinares-Moya D. Brugada phenocopy induced by a lethal methanol intoxication. Eur J Case Rep Intern Med. 2020; 7(2):001374.
11	Kudo T, Lahey R, Hirschfeld CB, Williams MC, Lu B, Alasnag M, et al. Impact of COVID-19 pandemic on cardiovascular testing in Asia: the IAEA INCAPS-COVID study. JACC: Asia. 2021; 1(2):187-99. doi: 10.1016/j.jacasi.2021.06.002
12	Rakus A, Kroczak M, Ruszkowski P. Methanol poisoning- -case report. Przegl Lek 2005; 62(6):514-6.
13	Pavri BB, Siu H, Andrikopoulou E, Ho R, DeCaro M. T-wave slopes: a novel method for assessment of repolarization dispersion from surface ECGs with prolonged QT as compared to normal ECGs. J Am Coll Cardiol. 2014; 63(12):A1638. doi: 10.1016/S0735-1097(14)61641-7
14	Strebel I, Twerenbold R, Wussler D, Boeddinghaus J, Nestelberger T, du Fay de Lavallaz J, et al. Incremental diagnostic and prognostic value of the QRS-T angle, a 12-lead ECG marker quantifying heterogeneity of depolarization and repolarization, in patients with suspected non-ST-elevation myocardial infarction. Int J Cardiol. 2019; 277:8-15. doi: S0167-5273(18)31696-6 pmid: 30274750
15	Heijman J, Crijns HJGM. T-wave right slope provides a new angle in the prediction of drug-induced ventricular arrhythmias. Cardiovasc Drugs Ther. 2015; 29(5):411-3. doi: 10.1007/s10557-015-6620-7 pmid: 26438190
16	Kamath SA, Meo Neto Jde P, Canham RM, Uddin F, Toto KH, Nelson LL, et al. Low voltage on the electrocardiogram is a marker of disease severity and a risk factor for adverse outcomes in patients with heart failure due to systolic dysfunction. Am Heart J. 2006; 152(2):355-61. doi: 10.1016/j.ahj.2005.12.021

Mortality-related electrocardiogram indices in methanol toxicity

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 1

References 16

Related Articles 0

Recommended Articles

Comments