Document Detail

Predictors of ethylene glycol ingestion cases called into a regional poison center.
MedLine Citation:
PMID:  22231275     Owner:  NLM     Status:  MEDLINE    
Poison center consultations for potential toxic alcohol poisonings are challenging because blood levels are typically not immediately available. The primary objective of this study was to determine whether readily obtainable laboratory values can be used to accurately and rapidly diagnose these poisonings. Over a 15-month period, patients with a history of toxic alcohol ingestion or a metabolic acidemia (pH ≤ 7.30 or serum bicarbonate ≤ 18 mEq/L) that prompted a poison center consultation were enrolled. A predictive logistic regression model was used to assess the combined ability of serum pH, calcium, osmolar gap, and anion gap levels to predict a final diagnosis of toxic alcohol poisoning. There were 102 subjects included in the analysis. A total of 44% (45/102) patients had a final diagnosis of ethylene glycol (EG) poisoning. Higher levels of calcium, osmolar gap, and anion gap were independently associated with statistically significant or marginally significant increases in the odds of a final diagnosis of EG poisoning. The c-index was estimated at 0.81, indicating that the model showed a reasonable ability to discriminate EG cases from others. The final model had a sensitivity and specificity of 78% and 89%, respectively, and positive and negative predictive values of 84% and 83% respectively. The combination of elevated calcium, osmolar gap, and anion gap is associated with a high likelihood of EG poisoning, but clinician gestalt is still essential for its diagnosis. Further refinement of the model is needed.
M E Sutter; W A Al-Khameess; J L Abramson; B W Morgan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of medical toxicology : official journal of the American College of Medical Toxicology     Volume:  8     ISSN:  1937-6995     ISO Abbreviation:  J Med Toxicol     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-06-13     Completed Date:  2012-10-19     Revised Date:  2013-07-31    
Medline Journal Info:
Nlm Unique ID:  101284598     Medline TA:  J Med Toxicol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  130-4     Citation Subset:  IM    
Department of Emergency Medicine, University of California, Davis, Sacramento, CA 95817, USA.
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MeSH Terms
Calcium / blood
Ethylene Glycol / poisoning*
Hydrogen-Ion Concentration
Middle Aged
Reg. No./Substance:
107-21-1/Ethylene Glycol; 7440-70-2/Calcium

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