The Severity and Prognostic Markers of 148 Cases of Carbon Monoxide Poisoning by Burning Charcoal

Abstract

To identify and analyse the characteristics of carbon monoxide (CO) poisoning due to burning charcoal in our locality. Methods: This was a 3-year retrospective study. All patients presenting with CO poisoning by burning charcoal from August 1999 to December 2002 were recruited. The demographic data, initial vital signs, blood results, treatment regimens and outcomes were collected. Association between clinical outcomes and parameters were calculated. Results: The study identified 148 patients (mean age 34.7 years) suffering from CO poisoning by burning charcoal. One hundred and forty-six cases (98.6%) were suicidal. Twenty-five patients (16.9%) were unconscious (GCS ≤ 8) on arrival. The mean initial carboxyhaemoglobin (COHb) level was 21.0%. The mortality rate was 5.4%. Fifteen cases (10.1%) required intensive care. Twelve cases (8.1%) had neurological complications and five (3.4%) suffered from delayed neurological sequelae. Initial blood results showing hyperkalemia and acidosis were associated with likelihood of unconsciousness on arrival (p = 0.007, p = 0.019 respectively). Hyperkalemia and unconsciousness on arrival were associated with longer hospital stay (p < 0.001, p < 0.001 respectively) as well as likelihood of systemic complication (p < 0.001, p < 0.001 respectively). There was no relationship between co-ingestion, age, initial COHb level, initial systolic and diastolic blood pressure with consciousness level on arrival (p = 0.188, p = 0.846, p = 0.264, p = 0.224, p = 0.755 respectively). Age, initial COHb level, acidosis, initial systolic and diastolic blood pressure did not correlate with the duration of hospital stay (p = 0.679, p = 0.176, p = 0.501, p = 0.313, p = 0.868 respectively). Conclusion: Suicide almost accounted for all the CO poisonings by burning charcoal in our study group. It caused significant mortality and morbidity. Hyperkalemia, unconscious state and acidosis had prognostic values.

Plasma Lactate as a Prognostic Biomarker in Acute Carbon Monoxide Toxicity

“…These results were in agreement with Lam et al, (2006) who carried a study on 148 cases of acute carbon monoxide poisoning and found that acidosis had prognostic values in evaluation of severity. Neil et al, (2008) demonstrated that arterial pH was statistically significant predictor of death in patients with acute carbon monoxide poisoning.…”

“…Also Lam et al, (2006) performed a study on 148 patients suffering from CO poisoning. They found 25 patients (16.9%) were unconsciousness (GCS ≤ 8) on arrival.…”

Acute carbon monoxide poisoning in a regional hospital in Hong Kong: historical cohort study

“…According to Lam et al in 2006, 8 the incidence of DNS in Hong Kong was 3.4%, which was much lower than other reported rates of 10% to 30%. [2][3][4][5][6][7] The overall incidence of DNS is likely to have been underdiagnosed and under-reported in Hong Kong because of a lack of detailed neurological examination and neuropsychiatric tests during acute management and follow-up sessions.…”

Public Health Impacts of Exposure to Carbon Monoxide From Gas Appliances in UK Homes – Are We Missing Something?

“…Blood results showing hyperkalemia and acidosis were associated with unconsciousness upon arrival and greater duration of stay in hospital. Hyperkalemia, acidosis and unconsciousness were considered to be valuable prognostic factors of CO exposure [31].…”