Clinical Indicators of Hemodialysis and Mortality in Methanol Poisoning: A Retrospective Analysis

Methanol poisoning is a severe medical emergency associated with high morbidity and mortality. Methanol poisoning leads to metabolic acidosis, visual disturbances, and central nervous system complications. Early diagnosis and timely treatment, including hemodialysis, are critical in improving outcomes.

This study aimed to evaluate the clinical and laboratory predictors of mortality and the need for hemodialysis in methanol poisoning patients. It also sought to establish cutoff values for critical parameters that influence clinical decisions.

A single-center retrospective cross-sectional study was conducted on patients over 18 years of age with suspected methanol poisoning between 2010 and 2022. Demographic, clinical, and laboratory data were collected and analyzed. Predictive parameters for mortality and hemodialysis were identified using Receiver Operating Characteristic (ROC) analysis.

Sixty-four patients were included, with a mean age of 47.7 years and 92.2% being male. Mortality occurred in 29.7% of patients. ROC analysis identified a serum pH cutoff of ≤7.08 for mortality prediction (AUC: 0.894, P<0.001) and ≤7.315 for predicting the need for hemodialysis (AUC: 0.891, P<0.001). Serum bicarbonate levels were significant predictors, with a cutoff of ≤8.45 for mortality (AUC: 0.820, P<0.001) and ≤15.55 for hemodialysis (AUC: 0.883, P<0.001). Elevated lactate levels (cutoff ≥3.67 mmol/L) and an anion gap ≥27.25 were also strong predictors of mortality.

Early recognition of critical parameters such as serum pH, sodium bicarbonate, lactate, and anion gap are essential in managing methanol poisoning.