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Features and predictors of myocardial injury in carbon monoxide poisoned patients.
MedLine Citation:
PMID:  23349356     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: By contrast with neurologic injury, myocardial injury associated with carbon monoxide (CO) poisoning has not been well investigated. Therefore, this study assessed features and predictors of myocardial injury in CO poisoned patients. SUBJECTS AND METHODS: 250 CO poisoning cases that were diagnosed and treated by the emergency department of Wonju Christian Hospital from January 2006 to February 2012 were retrospectively reviewed. RESULTS: Fifty (20%) out of 250 patients with CO poisoning developed myocardial injury. Among those with elevated troponin I (Tn I), peak levels occurred at 11.0 (IQR, 4.5-18.5) h normalising by 65.0 (IQR 44.0-96.0) h. CO exposure time, and total and ICU admission length was longer (7.5 (IQR 3.7-10.0) h vs 3.0 (IQR 1.0-7.5) h, p<0.001; 3.5 (IQR 0.0-7.0) days and 0.0 (IQR 0.0-1.25) days vs 0.0 (IQR 0.0-2.0) days and 0.0 (IQR 0.0-0.0) days, p<0.001, respectively) in the myocardial vs non-myocardial injury group. The predictors of myocardial injury were male gender, Glasgow Coma Scale (GCS) ≤14, and CO exposure time ≥2 h (OR (95% CI) of 3.341 (1.171 to 9.531), 9.920 (3.763 to 26.150), and 7.743 (1.610 to 37.238), respectively). CONCLUSIONS: Myocardial injury developed in 20% of CO poisoned patients. Time to normalisation and of peak Tn I level in elevated Tn I group was 65.0 (IQR 44.0-96.0) h and 11.0 (IQR 4.5-18.5) h. Presence of myocardial injury was associated with poorer prognosis. Predictors of myocardial injury included male gender, GCS of 14 or less, or CO exposure times greater than 2 h.
Authors:
Yong Sung Cha; Kyoung Chul Cha; Oh Hyun Kim; Kang Hyun Lee; Sung Oh Hwang; Hyun Kim
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-24
Journal Detail:
Title:  Emergency medicine journal : EMJ     Volume:  -     ISSN:  1472-0213     ISO Abbreviation:  Emerg Med J     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100963089     Medline TA:  Emerg Med J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Emergency Medicine, Wonju College of Medicine, Yonsei University, Wonju city, Kangwon Province, Republic of Korea.
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