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Inpatient Burden and Mortality of Methanol Intoxication in the United States
Authors:Wisit Kaewput  Charat Thongprayoon  Tananchai Petnak  Api Chewcharat  Boonphiphop Boonpheng  Tarun Bathini  Saraschandra Vallabhajosyula  Wisit Cheungpasitporn
Institution:1. Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, Thailand;2. Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN, United States;3. Division of Pulmonary and Critical Care Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand;4. Department of Medicine, University of California, Los Angeles, CA, United States;5. Department of Internal Medicine, University of Arizona, Tuscon, AZ, United States;6. Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States;7. Division of Nephrology, Department of Internal Medicine, University of Mississippi Medical Center, Jackson, MS, United States
Abstract:BackgroundThis study aimed to assess inpatient prevalence, characteristics, outcomes, and resource utilization of hospitalization for methanol intoxication in the United States.Materials and MethodsA total of 603 hospitalized patients with a primary diagnosis of methanol intoxication from 2003 to 2014 were identified in the National Inpatient Sample database. The inpatient prevalence, clinical characteristics, treatments, outcomes, resource utilization, were investigated. Multivariable logistic regression was performed to identify factors independently associated with in-hospital mortality.ResultsThe overall inpatient prevalence of methanol intoxication among hospitalized patients was 6.4 cases per 1,000,000 admissions in the United States. The mean age was 38±18 (range 0–86) years. 44% used methanol for suicidal attempts. 20% of admissions required mechanical ventilation, and 40% required renal replacement therapy. The three most common complications were metabolic acidosis (44%), hypokalemia (18%), and visual impairment or optic neuritis (8%). The three most common end-organ failures were renal failure (22%), respiratory failure (21%), and neurological failure (17%). 6.5% died in the hospital. Factors associated with increased in-hospital mortality included alcohol drinking, hypernatremia, renal failure, respiratory failure, circulatory failure, and neurological failure. The mean length of hospital stay was 4.0 days. The mean hospitalization cost per patient was $43,222ConclusionThe inpatient prevalence of methanol intoxication in the United States was 6.4 cases per 1,000,000 admissions. The risk of in-hospital mortality mainly depended on the number of end-organ failures.
Keywords:Corresponding author  Charat Thongprayoon  MD  Division of Nephrology and Hypertension  Department of Medicine  Mayo Clinic  Rochester  MN  USA    Methanol  Intoxication  Epidemiology  Outcomes  Hospitalization
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