Outcome of Patients with Carbon Monoxide Poisoning at a Far-East Poison Center

Ku, Chung-Hsuan; Hung, Huei-Min; Leong, Wa Cheong; Chen, Hsiao-Hui; Lin, Jing; Huang, Wen‐Hung; Yang, Huang‐Yu; Weng, Cheng‐Hao; Lin, Chia Wei; Lee, Shwu-Hua; Wang, I‐Kuan; Liang, Ching‐Chung; Chang, Chiz‐Tzung; Lin, Wey‐Ran; Yen, Tzung‐Hai

doi:10.1371/journal.pone.0118995

Cited by 33 publications

(37 citation statements)

References 28 publications

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“…Suicide attempt by charcoal burning is an important etiology of COP in Taiwan, and we found that about one of five COP cases was a suicidal attempt. A hospital-based study observed a proportion up to 49.4% [26]. Suicide attempt by charcoal burning in this study was highest in the spring, but the proportion was quite close to the expected value (25%), and therefore we can infer that suicide is independent of season.…”

Section: Discussionsupporting

confidence: 76%

Demographic and clinical characteristics of carbon monoxide poisoning: nationwide data between 1999 and 2012 in Taiwan

Huang

Chen

et al. 2017

Scand J Trauma Resusc Emerg Med

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BackgroundCarbon monoxide poisoning (COP) is not uncommon, but nationwide epidemiological data are limited. We conducted a study in Taiwan to fill the data gaps.MethodsWe used a nationwide poisoning database to study all COP patients in Taiwan diagnosed between 1999 and 2012. We conducted descriptive analyses and compared the differences between the two sexes. In addition, we assessed the trends in suicide and mortality rates from 1999 to 2012.ResultsWe identified 25,912 COP patients with an almost equal female and male distribution (50.6% vs. 49.4%). The mean age was 36.0 years, and most of the patients were between 20 and 50 years old. The highest incidence rate in the year occurred during winter. While female patients were more likely to have mental disorders (35.9% vs. 28.1%, p < 0.001), male patients were more likely to be resulted from suicide attempts (22.9% vs. 17.7%, p < 0.001). In both sexes, the suicidal rate increased from 1999, reached the peak in 2007, and then decreased gradually. Hyperbaric oxygen therapy was performed in 24.2% of the patients. Neurological sequelae developed in 9.1% of the patients, and chronic respiratory failure and requirement of long-term care were observed in 5.0% and 0.1% of the patients. The 1-month and 3-month mortality rates were 1.6% and 5.0%. The 3-month mortality rate did not show significant change between 1999 and 2012.DiscussionThis study showed a whole picture of COP in Taiwan, which could add to the important knowledge of this disastrous problem in public health.ConclusionSome important findings, including higher percentages of mental disorders in female patients and suicide attempt in male patients, seasonal changes, and trends in mortality and morbidity (suicide) rates, may help developing strategies for prevention and treatment of COP.Electronic supplementary materialThe online version of this article (doi:10.1186/s13049-017-0416-7) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 76%

Demographic and clinical characteristics of carbon monoxide poisoning: nationwide data between 1999 and 2012 in Taiwan

Huang

Chen

et al. 2017

Scand J Trauma Resusc Emerg Med

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“…CO not only reduces both the oxygencarrying capacity of hemoglobin and oxygen delivery to tissues, but also, binds to the cytochrome oxidase system to reduce cellular utilization of oxygen. Therefore, it suggested that central nervous system and myocardium's are most sensitive tissue to CO toxicity [27].…”

Section: Discussionmentioning

confidence: 99%

A Study of Acute Poisoning Cases Admitted to the University Hospital Emergency Department in Tabriz, Iran

et al. 2017

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Chemical substances have an important threat due to extensive use in medicine, agriculture, industry and environment. In this retrospective study, etiological and demographic characteristics of acute poisoning cases admitted to a hospital in Iran were investigated. We compared these data with those reported from other parts of the country and the international experiences to evaluate any difference if exists. 7 052 poisoned cases admitted to the hospital from April 2006 to March 2013, by data collected from the medical record in poison center section. According to our results there is a predominance of male patients and the majority of the poisoned patients were between 20-30 years old. Drug poisoning was the most common cause of poisonings. The most frequently involved drugs were benzodiazepines and antidepressants. The seasonal distribution of our study showed a peak in summer. To prevent acute poisonings, the social education about the risk assessment of central nervous system-acting drugs and reduction of the exposure period of people to pesticides are recommended. This study suggested a proper educational program for the public and primary care units. Our results provide useful information for preventive strategies.

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“…1 It constitutes an important part of those patients who are admitted due to poisoning to pediatric emergency clinics. 2,3 Especially during the winter months, coal stoves which are not adequately maintained, fires, and water heaters are the most common sources. Carbon monoxide rapidly binds to the iron atom in the hemoglobin structure when taken into the body and forms carboxyhemoglobin (COHb).…”

Section: Introductionmentioning

confidence: 99%

Factors that Affect Prognosis and Morbidity in Pediatric Patients with Carbon Monoxide Poisoning

Seçilmiş¹,

Öztürk²

2018

cayd

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Carbonmonoxide poisoning continues to be a major health problem worldwide, especially in developing countries, and constitutes an important part of the patients admitted to the pediatric emergency clinics due to poisoning. The aim of this study was to evaluate the correlation between clinical severity, morbidity, hospital stay, intensive care need, and full systemic effects in patients who were followed up and treated for carbon monoxide poisoning in our pediatric emergency clinic. Methods: The study was performed between January 2013 and 2015. We included patients under 18 years of age who were admitted to the pediatric emergency with carbon monoxide poisoning. Assessments were made prospectively. The epidemiological characteristics, complaints, physical examination and vital findings of all patients were recorded. Carboxyhemoglobin (COHb) level, oxygen saturation, electrocardiography, complete blood count, liver and kidney functions, and cardiac enzymes were studied, and Glasgow Coma scale (GCS) was calculated. Results: The mean length of hospital stay for 232 patients was calculated as 7.08±1 hours and the mean duration of exposure to carbon monoxide gas was 3.17±2.5 hours. Higher COHb levels and cardiotoxicity were detected in patients with a longer duration of exposure and a lower GCS and an increased intensive care need (p<0.01). There was no correlation between COHb levels and clinical severity, GCS, or intensive care unit need. However, it was found that high COHb levels (especially above 30%) increased cardiac injury and neurological symptoms but did not cause a permanent sequela (p<0.05). None of the patients had permanent neurological, cardiac, or renal damage. Conclusion: We found that duration of exposure is the most important and accurate parameter for the evaluation of clinical course and morbidity. In patients with high COHb levels, the effects are more prominent, however, we considered that there was no change in sequelae at long-term follow up.

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Outcome of Patients with Carbon Monoxide Poisoning at a Far-East Poison Center

Cited by 33 publications

References 28 publications

Demographic and clinical characteristics of carbon monoxide poisoning: nationwide data between 1999 and 2012 in Taiwan

Demographic and clinical characteristics of carbon monoxide poisoning: nationwide data between 1999 and 2012 in Taiwan

A Study of Acute Poisoning Cases Admitted to the University Hospital Emergency Department in Tabriz, Iran

Factors that Affect Prognosis and Morbidity in Pediatric Patients with Carbon Monoxide Poisoning

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