Sivas Numune State Hospital, Sivas, Turkey.
Ankara Educational Research Hospital, Ankara, Turkey.
Am J Emerg Med. 2019 Jul;37(7):1254-1259. doi: 10.1016/j.ajem.2018.09.017. Epub 2018 Sep 15.
Carbon monoxide (CO) poisoning is very common worldwide. In this study, we aimed to evaluate the predictivity of neuro psychosis in carbon monoxide poisoning by the admission levels of red cell distribution (RDW), mean platelet volume (MPV) and troponin I levels which can be measured quickly and easily in the emergency department (ED).
This single center observational study included a total of 216 consecutive patients who presented to the ED due to CO poisoning between January 2009 and December 2013. The diagnosis of CO poisoning was made according to the medical history and carboxyhemoglobin (COHb) level of >5%. According to the carboxyhemoglobin levels, the patients were classified as mildly (COHb < 20%) and severely poisoned (COHb > 20%). In addition, patients were divided into 2 groups, i.e., those with positive (>0.05 ng/mL for our laboratory) and negative (<0.05 ng/mL for our laboratory) troponin levels.
Patients mean age was 52.58 ± 10.58. 57.9% of the patients had high troponin levels and 51.9% were poisoned severely according to COHb levels. Patients with positive troponin and COHb had longer CO exposure time and higher neutrophil, lymphocyte, mean platelet volume (MPV), COHb and red cell distribution width (RDW) levels at the index admission following CO poisoning than patients with negative troponin (p < 0.05). Age, COHb level, CO exposure time, MPV and RDW (p = 0.001, p < 0.05) remained associated with an increased risk of troponin positivity following adjustment for the variables that were statistically significant.
In patients presenting to the ED with CO poisoning, RDW and MPV can be helpful for risk stratification of neuropsychosis.
一氧化碳（CO）中毒在全球范围内非常普遍。在这项研究中，我们旨在通过入院时的红细胞分布宽度（RDW）、平均血小板体积（MPV）和肌钙蛋白 I 水平来评估 CO 中毒后神经精神病的预测性，这些指标在急诊科（ED）中可以快速、简便地测量。
本单中心观察性研究共纳入 2009 年 1 月至 2013 年 12 月期间因 CO 中毒而到急诊科就诊的 216 例连续患者。根据病史和碳氧血红蛋白（COHb）水平＞5%，诊断为 CO 中毒。根据 COHb 水平，患者分为轻度（COHb＜20%）和重度（COHb＞20%）中毒。此外，患者分为肌钙蛋白阳性（＞0.05ng/mL，我们实验室）和肌钙蛋白阴性（＜0.05ng/mL，我们实验室）两组。
患者的平均年龄为 52.58±10.58 岁。57.9%的患者肌钙蛋白水平升高，51.9%的患者根据 COHb 水平为重度中毒。与肌钙蛋白阴性的患者相比，肌钙蛋白阳性和 COHb 的患者在 CO 暴露后有更长的 CO 暴露时间，入院时中性粒细胞、淋巴细胞、平均血小板体积（MPV）、COHb 和红细胞分布宽度（RDW）水平更高（p＜0.05）。在校正了有统计学意义的变量后，年龄、COHb 水平、CO 暴露时间、MPV 和 RDW（p=0.001，p＜0.05）与肌钙蛋白阳性的风险增加仍然相关。
在因 CO 中毒到急诊科就诊的患者中，RDW 和 MPV 有助于神经精神病的危险分层。
