A 5-year assessment on carbon monoxide poisoning in a referral center in Tehran-Iran

Abstract

Background: Carbon monoxide (CO) poisoning results in hundreds of deaths and thousands of emergency department visits all over Iran annually. In this study, we aim to provide an epidemiologic analysis of this poisoning in different consciousness levels. Methods: This single-center retrospective study was conducted at a referral poison center from March 21, 2007 to March 19, 2012 in Tehran, Iran. All CO poisoned children and adults who hospitalized were evaluated based on their on-arrival consciousness level. Results: Two-hundred-sixty patients with pure CO poisoning were enrolled with the majority of males (55.4%). CO exposure was unintentional in 99.6% of cases. The average period between CO exposure and the patients' hospital admission was 6.4 hours (SD = 11.2). Most of the toxicities had occurred at home (73.5%). On arrival acid-base status revealed respiratory acidosis cases in 11.9% of cases. Central nervous system imaging revealed 6.2% abnormal finding. Typically, patients presented with vomiting (25.8%), nausea (22.7%), and dizziness (11.3%). Twenty-nine patients (11.2%) needed intubation and mechanical ventilation. Thirty-six patients admitted to ICU with a median [IQR] hospital stay of 6 [2, 18] days. Ultimately, 202 (78.6%) patients discharged and 47 (18.3%) left the hospital against medical advice, 5 (1.9%) died, and 10 (3.8%) experienced sequellae. Two patients (0.8%), were transferred to other hospitals for specialized care. Conclusions: The incidence and mortality rate of CO poisoning in the current study are still higher than many other parts of the world. Ongoing health prevention strategies are not efficiently working. Hence, constant public education and warning about CO toxicity should be highlighted.

Carbon Monoxide Poisoning in Kuwait: A Five-Year, Retrospective, Epidemiological Study

“…Our analysis showed that male and female CO-poisoning victims had similar mean ages (males, 24-38 years; females, 23-38 years). This age range is consistent with that of Rahimi et al (2019) (18-37 years), who reported fatal cases of CO poisoning in Iran [23]. Previous studies have revealed that the COHb concentration at the time of death is usually higher in younger victims than the elderly [24][25][26].…”

“…Deaths from CO intoxication in Kuwait occurred most often (26 cases~44%) during the winter (December-February). This result correlates with other reports, with deaths related to CO poisoning being more common in cold weather [11,13,23,28]. This phenomenon may be explained using various methods used to maintain a warm indoor environment, including gas heating appliances, coal heaters and stoves and gasoline-powered electric generators, all of which produce CO due to incomplete combustion [29].…”

“…The mortality rate among males (68%) was more than double that among females (32%). A similar male predominance has been reported in other published studies in the Middle East [11,13,23]. Such sex-based differences cannot be explained with available data.…”