Rahimi Mitra, Aghabiklooei Abbas, Nasouhi Soheil, Mashayekhian Mohammad, Ghoochani Ahmad, Yousefi Yavar, Hassanian-Moghaddam Hossein
Department of Clinical Toxicology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Forensic Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Int J Prev Med. 2019 Jul 5;10:116. doi: 10.4103/ijpvm.IJPVM_338_18. eCollection 2019.
Carbon monoxide (CO) poisoning results in hundreds of deaths and thousands of emergency department visits all over Iran annually. In this study, we aim to provide an epidemiologic analysis of this poisoning in different consciousness levels.
This single-center retrospective study was conducted at a referral poison center from March 21, 2007 to March 19, 2012 in Tehran, Iran. All CO poisoned children and adults who hospitalized were evaluated based on their on-arrival consciousness level.
Two-hundred-sixty patients with pure CO poisoning were enrolled with the majority of males (55.4%). CO exposure was unintentional in 99.6% of cases. The average period between CO exposure and the patients' hospital admission was 6.4 hours (SD = 11.2). Most of the toxicities had occurred at home (73.5%). On arrival acid-base status revealed respiratory acidosis cases in 11.9% of cases. Central nervous system imaging revealed 6.2% abnormal finding. Typically, patients presented with vomiting (25.8%), nausea (22.7%), and dizziness (11.3%). Twenty-nine patients (11.2%) needed intubation and mechanical ventilation. Thirty-six patients admitted to ICU with a median [IQR] hospital stay of 6 [2, 18] days. Ultimately, 202 (78.6%) patients discharged and 47 (18.3%) left the hospital against medical advice, 5 (1.9%) died, and 10 (3.8%) experienced sequellae. Two patients (0.8%), were transferred to other hospitals for specialized care.
The incidence and mortality rate of CO poisoning in the current study are still higher than many other parts of the world. Ongoing health prevention strategies are not efficiently working. Hence, constant public education and warning about CO toxicity should be highlighted.
在伊朗，一氧化碳（CO）中毒每年导致数百人死亡，数千人前往急诊科就诊。在本研究中，我们旨在对不同意识水平下的这种中毒情况进行流行病学分析。
本单中心回顾性研究于2007年3月21日至2012年3月19日在伊朗德黑兰的一家转诊中毒中心进行。所有住院的CO中毒儿童和成人根据其入院时的意识水平进行评估。
纳入了260例单纯CO中毒患者，其中男性占大多数（55.4%）。99.6%的病例中CO暴露为意外。CO暴露与患者入院之间的平均间隔时间为6.4小时（标准差 = 11.2）。大多数中毒事件发生在家中（73.5%）。入院时酸碱状态显示11.9%的病例存在呼吸性酸中毒。中枢神经系统影像学检查显示6.2%有异常发现。患者通常表现为呕吐（25.8%）、恶心（22.7%）和头晕（11.3%）。29例患者（11.2%）需要插管和机械通气。36例患者入住重症监护病房，住院时间中位数[四分位间距]为6[2, 18]天。最终，202例（78.6%）患者出院，47例（18.3%）患者自行出院，5例（1.9%）死亡，10例（3.8%）出现后遗症。2例患者（0.8%）被转至其他医院接受专科护理。
本研究中CO中毒的发病率和死亡率仍高于世界其他许多地区。现行的健康预防策略效果不佳。因此，应加强对公众关于CO毒性的持续教育和警示。
