THE ANALYSIS OF CARBON MONOXIDE POISONING CASES PRESENTED TO THE EMERGENCY DEPARTMENT OF A UNIVERSITY HOSPITAL

Abstract

Introduction: Carbon monoxide poisoning is one of the most leading poisoning causing death through worldwide, although its exact incidence is yet to be determined. Carbon monoxide is a colorless and odorless gas that binds to hemoglobin and cellular oxidative enzymes with a higher affinity than oxygen, causing tissue hypoxia. Hypoxia of heart and nervous system cells leads to neuropsychiatric and cardiological signs and symptoms.  In this study, we aimed to investigate the demographic characteristics of the carbon monoxide poisonings occurring in patients presenting to the emergency department. We also aimed to determine the clinical characteristics, and the factors affecting the mortality.

Material and Methods: We retrospectively reviewed the demographic and clinical characteristics of 1013 patients who admitted to our adult emergency department and were diagnosed with carbon monoxide poisoning for a period of two years. We recorded and analyzed age, gender, season of presentation, hospital admission rate, sources of poisoning, symptoms at admission, mortality rate, and carboxyhemoglobin and cardiac Troponin-I levels.

Results: The mean age of the study population was 36.2±16.2 years. 70.5% of the patients were admitted in winter seasons. 66.1% of the patients’ poisoning source was water heater and stove. The most frequent symptoms were nausea, headache, and dizziness. On multilogistic regression analysis the death rate was significantly correlated with age and cardiac Troponin I level.

Conclusion: Our results indicate that accidental carbon monoxide poisonings continue to be an important public health problem in regions with cold winter seasons. We believe that intensifying efforts for public education and efficient control of resources of poisoning are the key steps to prevent carbon monoxide poisonings.

Keywords

• Epidemiology,carbon-monoxide,poisoning

BİR ÜNİVERSİTE HASTANESİ ACİL SERVİSİNE BAŞVURAN KARBON MONOKSİT ZEHİRLENMESİ OLGULARININ ANALİZİ

Abstract

Giriş: Karbonmonoksit zehirlenmesi, insidansı kesin olarak bilinmemekle birlikte dünya çapında ölüme sebep olan başlıca zehirlenmelerden birisidir. Karbonmonoksit, hemoglobine ve hücresel oksidatif enzimlere oksijenden daha yüksek bir afiniteyle bağlanarak doku hipoksisine neden olan renksiz ve kokusuz bir gazdır. Kalp ve sinir sistemi hücrelerindeki hipoksi, nöropsikiyatrik ve kardiyolojik belirti ve bulgularının oluşmasına yol açar. Bu çalışmada karbonmonoksit zehirlenmesi nedeniyle acil servise başvuran olguların demografik ve klinik özelliklerini araştırmayı amaçladık.

Gereç ve Yöntem: Erişkin acil servisimize iki yıllık bir süre zarfında başvurup karbonmonoksit zehirlenmesi tanısı alan 1013 hastanın demografik ve klinik özelliklerini retrospektif olarak gözden geçirdik. Hastaların yaş, cinsiyet, başvuru mevsimi, hastane yatış oranı, zehirlenmenin kaynağı, başvuru belirtileri, mortalite oranı, karboksihemoglobin ve Troponin I seviyeleriyle ilgili bilgileri kayıt ve analiz ettik.

Bulgular: Çalışma popülâsyonunun ortalama yaşı 36.2±16.2’di. Hastaların %70,5’i kış mevsiminde başvuru yapmıştı. Hastaların %66,1’inin zehirlenme kaynağı sıcak su ısıtıcısı, gazla çalışan sobalardı. En sık bulgular bulantı, baş ağrısı ve sersemlik hissiydi. Multilojistik regresyon analizinde ölüm hızı ile yaş ve kardiyak Troponin I düzeyi arasında anlamlı ilişki olduğu tespit edildi.

Sonuç: Çalışmamızın sonuçları, karbonmonoksit zehirlenmesinin zorlu kış koşullarının hâkim olduğu bölgelerde halen önemli bir halk sağlığı problemi olduğunu ortaya koymaktadır. Toplumun eğitimi ve zehirlenme kaynaklarının ile karbonmonoksit zehirlenmesinin önlenebilir olacağını düşünmekteyiz.  

Keywords

• Epidemiyoloji,karbonmonoksit,zehirlenme

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