University of Medicine and Pharmacy "Grigore T. Popa", Iasi, Romania.
Emergency Department, Clinical Emergency County Hospital "St. Spiridon", Iasi, Romania.
Int Urol Nephrol. 2022 Jan;54(1):149-155. doi: 10.1007/s11255-021-02837-3. Epub 2021 Mar 18.
Despite the severity of ethylene glycol intoxication, there is a paucity of studies that analyze prognostic factors. This study aims to determine prognostic factors with impact on core outcomes like death and prolonged kidney injury (KI) in ethylene glycol poisoned patients.
We retrospectively assessed prevalence, clinical and biochemical features in one large data set from two regional hospitals from the North-East region of Romania, between January 2012 and October 2017. Secondly, we compared prognostic factors of cases treated with dialysis plus antidote (N = 28 patients) with cases who received antidote only and supportive therapy (N = 28 patients).
Of the 56 cases included, 16 deaths (28.57%) were recorded. The symptomatology at admission was more severe among patients requiring hemodialysis: a lower mean value for initial pH, lower initial alkaline reserve (AR) and higher mean values for initial serum creatinine (Cr1). The data analysis (survivors/deceased) showed a correlation between pH, Glasgow Coma Score (GCS), and increased mortality. In addition, we found a correlation between initial mean values for pH, AR (mmol/L), Cr1 (mg/dL), and peak Cr24 (mg/dL) with outcomes of RI or death.
Compared with survivors, patients who died or had prolonged kidney injury were more likely to exhibit clinical signs such as coma, seizures, and acidosis. Hemodialysis and antidote should be started early and continued until acidosis is corrected.
尽管乙二醇中毒的严重程度很高，但对于分析预后因素的研究却很少。本研究旨在确定对死亡率和延长的肾损伤（KI）等核心结果有影响的预后因素，这些患者为乙二醇中毒患者。
我们回顾性评估了罗马尼亚东北部两个地区医院的一个大型数据集在 2012 年 1 月至 2017 年 10 月之间的流行率、临床和生化特征。其次，我们比较了接受透析加解毒剂治疗的病例（N=28 例）和仅接受解毒剂和支持性治疗的病例（N=28 例）的预后因素。
在 56 例病例中，记录了 16 例死亡（28.57%）。需要血液透析的患者入院时的症状更为严重：初始 pH 值、初始碱性储备（AR）较低，初始血清肌酐（Cr1）平均值较高。数据分析（存活/死亡）显示 pH、格拉斯哥昏迷评分（GCS）与死亡率之间存在相关性。此外，我们还发现初始 pH 值、AR（mmol/L）、Cr1（mg/dL）和 Cr24 峰值（mg/dL）的平均值与 RI 或死亡的结果之间存在相关性。
与幸存者相比，死亡或发生延长性肾损伤的患者更可能出现昏迷、癫痫发作和酸中毒等临床症状。应尽早开始血液透析和解毒剂治疗，并持续进行直至酸中毒得到纠正。
