Open AccessThe Severity and Prognostic Markers of 148 Cases of Carbon Monoxide Poisoning by Burning Charcoal
Author(s) -
Lam KK,
Fung HT,
Kam CW
Publication year - 2006
Publication title -
hong kong journal of emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.145
H-Index - 12
eISSN - 2309-5407
pISSN - 1024-9079
DOI - 10.1177/102490790601300110
Subject(s) - medicine , unconsciousness , hyperkalemia , blood pressure , anesthesia , acidosis , carbon monoxide poisoning , metabolic acidosis , nigerians , surgery , poison control , emergency medicine , political science , law
Objective To identify and analyse the characteristics of carbon monoxide (CO) poisoning due to burning charcoal in our locality. Methods This was a 3‐year retrospective study. All patients presenting with CO poisoning by burning charcoal from August 1999 to December 2002 were recruited. The demographic data, initial vital signs, blood results, treatment regimens and outcomes were collected. Association between clinical outcomes and parameters were calculated. Results The study identified 148 patients (mean age 34.7 years) suffering from CO poisoning by burning charcoal. One hundred and forty‐six cases (98.6%) were suicidal. Twenty‐five patients (16.9%) were unconscious (GCS ≤ 8) on arrival. The mean initial carboxyhaemoglobin (COHb) level was 21.0%. The mortality rate was 5.4%. Fifteen cases (10.1%) required intensive care. Twelve cases (8.1%) had neurological complications and five (3.4%) suffered from delayed neurological sequelae. Initial blood results showing hyperkalemia and acidosis were associated with likelihood of unconsciousness on arrival (p = 0.007, p = 0.019 respectively). Hyperkalemia and unconsciousness on arrival were associated with longer hospital stay (p < 0.001, p < 0.001 respectively) as well as likelihood of systemic complication (p < 0.001, p < 0.001 respectively). There was no relationship between co‐ingestion, age, initial COHb level, initial systolic and diastolic blood pressure with consciousness level on arrival (p = 0.188, p = 0.846, p = 0.264, p = 0.224, p = 0.755 respectively). Age, initial COHb level, acidosis, initial systolic and diastolic blood pressure did not correlate with the duration of hospital stay (p = 0.679, p = 0.176, p = 0.501, p = 0.313, p = 0.868 respectively). Conclusion Suicide almost accounted for all the CO poisonings by burning charcoal in our study group. It caused significant mortality and morbidity. Hyperkalemia, unconscious state and acidosis had prognostic values.