Experience of carbon monoxide poisoning and the outcome predicting score: A multicenter retrospective study

Jen, Ying; Pan, Hsiu-Yung; Cheng, Fu-Jen; Chang, Ye-In; Chuang, Po-Chun

doi:10.1016/j.ajem.2022.05.012

Cited by 7 publications

(2 citation statements)

References 33 publications

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“…Risk factors related to early death after CO poisoning, such as the need for intubation during HBOT, severe metabolic acidosis, the initial loss of consciousness, re as a source of CO, and high COHb levels, have been reported [24]. Reported risk factors for DNS include age > 35 years, CO exposure for > 24h, serious disturbance of consciousness at emergency admission, prolonged disturbance of consciousness, elevated levels of creatine kinase, creatine kinase-MB and lactate dehydrogenase, and low Global Assessment Scale score [25].…”

Section: Discussionmentioning

confidence: 99%

Risk factors and Outcome Analysis of Delayed Neurological Sequelae in elderly patients with carbon monoxide poisoning

Xue

et al. 2023

Preprint

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Objective Carbon monoxide (CO) poisoning is one of the common causes of poisoning in patients and can result in significant neurological sequelae. However, few studies have focused on the elderly population. Method We retrospectively reviewed elderly (age≥60 years) with CO poisoning from non-fire accidents and non-suicid at at the 6th medical center PLA general hospital in China from 2013 to 2023. We analyzed the patients’ epidemiological characteristics and outcome; identified the risk factors for patients who developed delayed neurological sequelae (DNS) and long-term neurological sequelae (LNS); compared the data of patients who received hyperbaric oxygen (HBO) to those who received normobaric oxygen (NBO) therapy. Result A total of 167 elderly patients were enrolled. The annual case number decreased from 2013 to 2023, particularly during the cold months (November to February). The most common source of exposure was coal heating (89.8%). The most common presenting symptoms were consciousness changes (86.8%). Eighty-eight patients (52.3%) developed DNS, of which sixty-nine patients (78.4%) converted to LNS. The most common imaging manifestations were hypoxic ischemic damage in the basal ganglia (54.3%) and demyelination in white matter (45.7%). After multivariate analysis, initial GCS score and coma time were the independent risk factor for patients with DNS (p＜0.001). Interestingly, myocardial injury was more common in non DNS elderly patients than in DNS patients (p＜0.001); only coma time was an independent risk factor for patients with LNS (p＜0.001). There was no significant difference between HBO (p=0.196) and NBO (p=0.379) in the occurrence of DNS and LNS in elderly patients with CO poisoning. Conclusion: Only initial GCS score and coma time are the risk factors of DNS for elderly patients, and coma time alone is a high-risk factor for poor prognosis of CO poisoning in the elderly. Moreover, HBO is not superior to NBO in elderly patients with CO poisoning. Special attention should be given and follow-up should be performed to elderly patients, particularly those have longer coma time and CO exposure time, and lower initial GCS score in acute CO poisoning.

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Section: Discussionmentioning

confidence: 99%

Risk factors and Outcome Analysis of Delayed Neurological Sequelae in elderly patients with carbon monoxide poisoning

Xue

et al. 2023

Preprint

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“…The diagnosis of CO poisoning was made with a history of CO exposure, clinical findings and symptoms caused by CO poisoning, and blood carboxyhemoglobin (COHb) level [ 17 ]. Since COHb level may be low in patients with a long period of time between hospital admission and CO exposure, carbon monoxide poisoning was diagnosed using clinical symptoms, history, and carbon monoxide half-life in such patients [ 16 ].…”

Section: Methodsmentioning

confidence: 99%

The effect of full blood count and cardiac biomarkers on prognosis in carbon monoxide poisoning in children

et al. 2022

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Aims In this study, cardiac biomarkers, blood parameters, electrocardiography (ECG), and echocardiography were investigated in children with carbon monoxide (CO) poisoning, and the diagnostic value of these parameters was investigated. Methods The demographical, clinical, and laboratory data of children aged 0–18 years who were admitted to the pediatric emergency department due to CO poisoning between January 2019 and January 2022 were retrospectively scanned from medical records. The patients were divided into two groups as troponin-I positive and troponin-I negative. Results There were 107 children aged 0–18 years (average age, 10.46 ± 5.77 years; 51% female) with CO poisoning. There were 13 patients with troponin-I positive myocardial injury. Troponin-I was positive in 3 patients whose carboxyhemoglobin (COHb) level was below 2% at the time of admission. In one patient, troponin-I, which was normal at admission, increased by the 24th hour of hospitalization. Hyperbaric oxygen therapy was given due to headache in one patient, although the COHb level of that patient was below 25%. An NT-proBNP level of ≥ 219.5 ng/L predicted the development of troponin-I positivity with a sensitivity of 70% and a specificity of 86.7% (AUC, 0.967 (0.58–0.994); p = 0.017). White blood cell (WBC), neutrophil, neutrophil-to-lymphocyte ratio (NLR), immature granulocyte (IG), and IG% levels were found to be significantly higher in the troponin-positive patient group. Discussion and conclusion NT-proBNP has been shown to be an early diagnostic marker for myocardial dysfunction. Additionally, when cardiac markers are not available, full blood parameters may assist clinicians for patient treatment and referral.

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Methodological concerns about score of delayed neuropsychiatric sequelae after carbon monoxide poisoning

Shi

Zhang²

2023

The American Journal of Emergency Medicine

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Experience of carbon monoxide poisoning and the outcome predicting score: A multicenter retrospective study

Cited by 7 publications

References 33 publications

Risk factors and Outcome Analysis of Delayed Neurological Sequelae in elderly patients with carbon monoxide poisoning

Risk factors and Outcome Analysis of Delayed Neurological Sequelae in elderly patients with carbon monoxide poisoning

The effect of full blood count and cardiac biomarkers on prognosis in carbon monoxide poisoning in children

Methodological concerns about score of delayed neuropsychiatric sequelae after carbon monoxide poisoning

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