Abstract
Carbon monoxide (CO) is one of the most common poisoning substances worldwide. Since acute brain injury (ABI) is an important determinant of the neurological outcome in CO poisoning, screening for patients at a high risk of developing ABI is essential for the proper treatment. This study identified predictors of ABI in patients with CO poisoning. This prospective registry-based study was conducted in patients who visited a tertiary care hospital for CO poisoning from August 2016 to June 2020. ABI was defined as the presence of acute hypoxic lesions on diffusion-weighted magnetic resonance imaging. Multiple logistic regression analysis was performed to identify the predictors of ABI. Of 231 patients, 64 (27.7%) showed ABI. Multiple logistic regression analysis showed that a Glasgow Coma Scale (GCS) score <9 at presentation (odds ratio [OR] 3.28, 95% confidence interval (CI) 1.08–10.01), creatinine level >1.2 mg/dL (OR 3.04, 95% CI 1.16–8.01), and C-reactive protein (CRP) level >9.2 mg/L (OR 4.38, 95% CI 1.41–13.65) predicted ABI in cases of acute CO poisoning. In CO poisoning, the GCS score at presentation, and serum creatinine and CRP levels, were useful predictors of ABI, and may help clinicians identify high-risk patients for whom treatment should be prioritized.
Highlights
Carbon monoxide (CO) poisoning is common, being responsible for more than 50,000 emergency department (ED) visits per year in the United States (16 cases per 100,000 population) [1]
Engine exhaust, and furnace defects [2]. It is used by some individuals when attempting suicide; about 15,000 cases of deliberate CO poisoning are reported annually in the United States, of which two-thirds result in death [3]
A total of 371 CO poisoning patients were identified during the study period
Summary
Carbon monoxide (CO) poisoning is common, being responsible for more than 50,000 emergency department (ED) visits per year in the United States (16 cases per 100,000 population) [1]. Engine exhaust, and furnace defects [2]. It is used by some individuals when attempting suicide; about 15,000 cases of deliberate CO poisoning are reported annually in the United States, of which two-thirds result in death [3]. CO binds to myoglobin and mitochondrial cytochrome oxidase, and may cause injury through inflammation-induced brain lipid peroxidation [5]. Acute brain injury (ABI) caused by CO poisoning is associated with neurological sequelae. ABI can be confirmed by diffusion-weighted magnetic resonance imaging (DW-MRI) [8]
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