Hazard stratification of acute carbon monoxide poisoning and study on the prognosis of related patients

Abstract

Objective To analyze treatment methods for patients with acute carbon monoxide poisoning and features of delayed encephalopathy following acute carbon monoxide poisoning (DEACMP). Methods A retrospective analysis was made by using 201 cases of patients, who were admitted for emergency treatment upon first clinical visit from January 2007 to February 2009 due to coma induced by acute carbon monoxide poisoning (ACOP). The patients were stratified into 2 groups according to coma time. Group A consisted of patients with a coma time less than 2 h and Group B consisted of patients with a coma time over 2 h. The latter group was subdivided according to coma time and age. Patients of Group A were given hyperbaric oxygen (HBO) treatment, and/ or normobarie oxygen (NBO)and patients of Group B given integrated hyperbaric oxygen treatment. Incidence rate of delayed encephalopathy following acute carbon monoxide poisoning was analyzed statistically. Results Total incidence rate of DEACMP in ACOP patients with conscious disorder was 3.5%. In Group A, there were no patients with DEACMP; and rate of DEACMP for patients in Group B was 10.3%. And in Group B, incidence rate of DEACMP for patients with a coma time over 2 h was 27.3%, indicating a significant statistical difference, when compared with that of those patients with a coma time for 2～6 h (P 0.05). Conclusions The degree of unconsciousness and coma time were high risk factors of DEACMP for patients with acute carbon monoxide poisoning. Integrated HBO treatment based on risk stratification of DEACMP might result in a relatively low incidence rate of DEACMP. Key words: Acute carbon monoxide poisoning; Hyperbaric oxygen; Stratification treatment