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Experience of carbon monoxide poisoning and the outcome predicting score: A multicenter retrospective study.

Authors :
Chi, Ying Jen
Pan, Hsiu-Yung
Cheng, Fu-Jen
Chang, Ye-In
Chuang, Po-Chun
Source :
American Journal of Emergency Medicine; Aug2022, Vol. 58, p73-78, 6p
Publication Year :
2022

Abstract

<bold>Background: </bold>Carbon monoxide poisoning (COP), resulting from accidental and intentional exposure, is a leading cause of fatal poisoning worldwide. Except for early death, neurological sequelae are common and impose a large burden on patients, caregivers, and the society.<bold>Materials and Methods: </bold>This retrospective study included patients who visited the emergency departments (EDs) of the medical institutes of Chang Gung Memorial Hospital after COP with a carboxyhemoglobin level > 10% between January 2009 and October 2018. Patients who experienced out-of-hospital cardiac arrest (OHCA) were excluded. Poor outcome was defined as mortality or a Glasgow coma scale (GCS) <13 at discharge. Stepwise regression analysis was performed, and a receiver operating characteristic (ROC) curve was applied to analyze our newly created scoring system for prognosis prediction.<bold>Results: </bold>This study enrolled 1171 patients. Fire scene (F) (aOR, 20.635; 95% CI, 8.345-51.023), intentional CO exposure (I) (aOR, 2.634; 95% CI, 1.335-5.196), respiratory failure (R) (aOR, 9.944; 95% CI, 5.533-17.873), every point of reduced GCS (E) (aOR, 1.253; 95% CI, 1.186-1.323), and diabetes mellitus (D) (aOR, 2.749; 95% CI, 1.201-6.292) were identified as predictors of poor outcomes. The FIRED score was created.<bold>Conclusion: </bold>The FIRED score could predict the outcomes of non-OHCA patients with a carboxyhemoglobin level > 10% after COP using five factors that can be obtained by history taking and basic examination. An FIRED score ≥ 10 was associated with a poor outcome (sensitivity, 89.6%; specificity, 82.4%; AUC0.930). [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
07356757
Volume :
58
Database :
Supplemental Index
Journal :
American Journal of Emergency Medicine
Publication Type :
Academic Journal
Accession number :
157947296
Full Text :
https://doi.org/10.1016/j.ajem.2022.05.012