Objective To analyze the clinical characteristics and death-related risk factors of patients with acute ethylene glycol (EG) poisoning in order to guide clinical diagnosis and prognosis evaluation.

Methods A retrospective analysis was done on the clinical data of 43 patients with acute EG poisoning admitted to the Emergency Department and ICU in 3 hospitals in Xinjiang from January 2010 to December 2022. The patients were divided into survival and death groups based on their in-hospital survival status. The differences in various indicators between the two groups were compared. Binary logistic regression analysis was used to determine independent risk factors affecting prognosis, and the receiver operating curve characteristic (ROC) curve was used to analyze the predictive ability of relevant indicators for the prognosis of acute EG poisoning patients.

Results Among 43 patients, 31 were male (72.09%), and 32 cases were accidental ingestion (74.42%). There were 9 cases of death (20.93%) and 41 cases (95.35%) of acute kidney injury. The patients had varying degrees of consciousness disorders GCS score (9.767 ±1.900) points. The values of lactate, potassium ions, anion gap (AG), osmolar gap (OG), and blood creatinine were higher than the normal reference range. Results of the binary logistic regression analysis indicated that a higher AG was associated with an increased risk of mortality (OR = 1.424, P < 0.05); higher GCS scores were associated with a decreased risk of mortality (OR = 0.161, P < 0.05); and patients treated with ethanol had a reduced risk of mortality compared to those without ethanol treatment (OR = 0.003, P < 0.05). ROC analysis showed that the area under the curve (AUC) for the combination of AG and GCS scores was 0.918 (95%CI: 0.836 to 1), which was higher than the AUC for AG alone (0.886, 95% CI: 0.771 to 1) and the AUC of GCS score (0.842, 95%CI: 0.718 to 0.965).

Conclusions Acute ethylene glycol (EG) poisoning was characterized by high AG metabolic acidosis with elevated OG or altered consciousness, often leading to acute kidney injury. High AG, low GCS scores, and a lack of ethanol treatment were independent risk factors for mortality. The prediction accuracy of the patient's prognosis could be improved with the combination of AG and GCS scores.