Characteristics of patients with carbon monoxide poisoning due to smoke inhalation and pre-hospital factors related to intensive care unit admission of these patients: a nationwide observational study

Abstract

This study aimed to investigate the pre-hospital clinical status of patients with carbon monoxide (CO) poisoning by smoke inhalation and the pre-hospital factors associated with these patients’ admission to the intensive care unit (ICU). In this observational study from January 2016 to December 2018, the National Fire Agency’s first aid activity log on patients with smoke inhalation was matched with National Emergency Department Information System’s patient data with CO poisoning and further analyzed retrospectively. Multiple logistic regression analysis was conducted to identify the relevant pre-hospital associative factors for the decision to admit a patient with CO poisoning to the ICU. Of the 4422 patients with CO poisoning included in the study, 358 (8.09%) were admitted to the ICU. In such patients transported by pre-hospital emergency medical services, age (odds ratio [OR], 1.020; 95% confidence interval [CI], 1.010–1.029), verbal (OR, 3.564; 95% CI, 2.390–5.315), pain (OR, 4.011; 95%CI, 2.661–6.045), unconsciousness (OR, 5.728; 95% CI, 2.708–12.113), SBP (OR, 0.979; 95% CI, 0.969–0.989), HR (OR, 1.011; 95% CI, 1.004–1.018), SpO2 (OR, 0.965; 95% CI, 0.946–0.985), O2 supply (OR, 1.725; 95% CI, 1.143–2.603), use of nasal prongs (OR, 0.504; 95% CI, 0.281–0.905), and intentional inhalation (OR, 2.282; 95% CI, 1.659–3.139) were independently associated with ICU admission. Our study demonstrated that age, mental change, SBP, HR, SPO2, O2 supply, use of nasal prongs, and intentional inhalation in patients with CO poisoning were associated with their ICU admission.