Usefulness of a modified poisoning severity score for predicting prognosis in acute carbon monoxide poisoning

Lee, Je Seop; Kim, Tae Youn; Bae, Kyung Su; Kim, Hyun

doi:10.1016/j.ajem.2021.10.027

Cited by 5 publications

(5 citation statements)

References 28 publications

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“…CPC is now the gold standard for assessing neurological recovery after cardiac arrest 11 . In an analysis of intoxicated patients, CPC was also used to monitor recovery from cardiac arrest induced by intoxication, as well as carbon monoxide poisoning, which can cause hypoxic brain damage 23–26 . This study included patients with cardiac arrest and carbon monoxide poisoning.…”

Section: Discussionmentioning

confidence: 99%

“…11 In an analysis of intoxicated patients, CPC was also used to monitor recovery from cardiac arrest induced by intoxication, as well as carbon monoxide poisoning, which can cause hypoxic brain damage. [23][24][25][26] This study included patients with cardiac arrest and carbon monoxide poisoning. To our knowledge, no studies have investigated the outcomes at 1 month among intoxicated patients, except for those with cardiac arrest or carbon monoxide poisoning.…”

Section: Variablesmentioning

confidence: 99%

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Outcome in intoxicated patients transported by a physician‐staffed helicopter in Japan from 2015 to 2020

Yanagawa,

Takeuchi,

Nagasawa

et al. 2023

Acute Medicine & Surgery

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AimWe retrospectively investigated the current status of poisoned patients who had been transported by a physician‐staffed helicopter emergency medical service and their final outcomes using data from the JAPAN DOCTOR HELICOPTER REGISTRY SYSTEM.MethodsThe following details of dispatch activity were collected from the database of the JAPAN DOCTOR HELICOPTER REGISTRY SYSTEM: patient age and sex, timing of dispatch request, presence of cardiac arrest, vital signs, medical intervention, main etiology of intoxication, and final outcome. The patients were divided into two groups: those with a good outcome and those with a poor outcome. The variables were compared between the two groups.ResultsA total of 336 patients were intoxicated. Psychotropic drug overdose was the dominant cause, followed by carbon monoxide and ethanol. The median Glasgow Coma Scale score was significantly higher in the good outcome group than in the poor outcome group. The rates of cardiac arrest, interventions to secure an airway and/or assist with ventilation, and drug administration were significantly lower in the good outcome group than in the poor outcome group. There were no records concerning the decontamination of the intoxicating substance at the scene or during air evacuation.ConclusionThe study suggests that various factors may influence the outcomes of patients with different types of intoxication. These findings offer valuable insights that could help to establish effective treatment strategies and the operation of doctor helicopters for intoxicated patients.

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Section: Discussionmentioning

confidence: 99%

Section: Variablesmentioning

confidence: 99%

Outcome in intoxicated patients transported by a physician‐staffed helicopter in Japan from 2015 to 2020

Yanagawa,

Takeuchi,

Nagasawa

et al. 2023

Acute Medicine & Surgery

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“…Although COHb levels in blood gases have been used as diagnostic tests, the weakness of the correlationbetween COHb levels and clinical trials is still a matter of debate. [1,2,21] Even in patients with high COHb levels, 20-30% of the clinic picture is shown to be asymptomatic. [6] The time until the measurement of COHb level, the concentration of the exposed CO, exposure time, baseline status of exposed patient, individual sensitivity, and the amount of treatment O 2 during treatment are thought to play a role in this case.…”

Section: Discussionmentioning

confidence: 99%

Does Hypoxia Inducible Factor 1? Levels Contribute to the Diagnosis and Follow Up of Carbon Monoxide Poisoning?

Gedik

2023

EJMI

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non-irritating toxic gas. COP is one of the common types of poisoning in the world.Approximately 50000 patients are admitted toemergency departmentswith COPin a yearin the USA. [1,2] The incidence of COP increases due to the use of carbon-based fuels, and the use of flue-free stoves, barbecues and water heaters in small areas with insufficient ventilation is the most important cause of poisoning in our country. [3,4] CO leads to various tempo-rary and permanent effects on human bodydepending on the time of exposure and the effects of treatment. [5] Heart and brain are the most responsive organs to COP due to their high metabolic rates, and neuropsychiatric. [6] Classical complaints in acute intoxications are headache, dizziness, nausea, vomiting, dyspnea, and chest pain. Findings range from minimal symptoms to nonresponsiveness, hypotension, severe acidemia and/or acute respiratory failure. [7] Objectives: This study aimed to evaluate the levels of HIF-1α (Hypoxia-Induced Factor) in acute Carbonmonoxide poisoning (COP) at admission and after the treatment. Methods: The study was conducted prospectively and cross-sectionally in the adult Emergency Department of our hospitalbetween 01. 01.2018 and 30.06.2018. Results: This study included 42 patients admitted to the emergency department with suspected COP. When the cases were grouped according to carboxyhemoglobin (COHb) level, the levels of 38.1% (n=16) and 61.5% (n=26) of the patients were found to be moderate and severe, respectively. There were no mild cases among our cases. After the treatment, HIF-1α, COHb, mean platelet volume (MPV), lymphocyte, lactate, pH and base deficit values were statistically significantly lower than the pre-treatment values(p value<0.0001, <0.0001, <0.0001, 0.039, <0.0001, 0.032, 0.01, respectively). A positive correlation was found between COHb level and white blood cell (WBC), neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), pH, HIF-1α and lactate levels. There was a statistical significance only at pH value (p=0.001, r=0.474). Conclusion: HIF-1α increases significantly in parallel withCarbonmonoxide(CO) exposure and these high levels are positively correlated with COHb concentrations. Based on this data, COHb concentrations are still the best biomarkers in the diagnosis and follow-up of COP.

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“…These factors include advanced age, prolonged CO exposure, high carboxyhemoglobin levels, altered mental status upon presentation, prolonged coma, delayed time to treatment, metabolic acidosis, elevated lactate levels, myocardial injury with high troponin T levels, and early brain computed tomography findings (such as globus pallidus or white matter lesions). In additionally, Glasgow Coma Scale score, Poison Severity Score, CO-modified Poison Severity Score, and Sequential Organ Failure Assessment score have been identified as important predictors of COP prognosis 2–6 …”

mentioning

confidence: 99%

“…In additionally, Glasgow Coma Scale score, Poison Severity Score, CO-modified Poison Severity Score, and Sequential Organ Failure Assessment score have been identified as important predictors of COP prognosis. [2][3][4][5][6] To obtain a comprehensive evaluation of a patient's overall status and prognosis in cases of COP, it is crucial to consider multiple inflammatory biomarkers and clinical variables, as well as incorporate a comprehensive risk stratification score. Although the study by Guven et al adds to our understanding of the potential role of MPV and RDW in predicting COP severity, relying solely on these markers may not provide sufficient information to accurately predict patient outcomes and guide treatment decisions, particularly in cases where hyperbaric oxygen therapy is needed.…”

mentioning

confidence: 99%

Beyond Complete Blood Cell Count Parameters

Golcuk,

Ergözen,

Golcuk

2023

Pediatr Emer Care

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Usefulness of a modified poisoning severity score for predicting prognosis in acute carbon monoxide poisoning

Cited by 5 publications

References 28 publications

Outcome in intoxicated patients transported by a physician‐staffed helicopter in Japan from 2015 to 2020

Outcome in intoxicated patients transported by a physician‐staffed helicopter in Japan from 2015 to 2020

Does Hypoxia Inducible Factor 1? Levels Contribute to the Diagnosis and Follow Up of Carbon Monoxide Poisoning?

Beyond Complete Blood Cell Count Parameters

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