대한임상독성학회지 (Journal of The Korean Society of Clinical Toxicology)

  • 제14권2호
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  • Pages.115-121
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  • 2016
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  • 1738-1320(pISSN)
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  • 2508-6332(eISSN)
대한임상독성학회 (Korean society of Clincal Toxicology)
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의식이 명료한 일산화탄소 중독환자를 대상으로 응급실에서 시행한 간이정신상태검사의 임상적 의의

Incidence and Features of Cognitive Dysfunction Identified by Using Mini-mental State Examination at the Emergency Department among Carbon Monoxide-poisoned Patients with an Alert Mental Status

  • 육현 (연세대학교 원주의과대학 응급의학교실) ;
  • 차용성 (연세대학교 원주의과대학 응급의학교실) ;
  • 김현 (연세대학교 원주의과대학 응급의학교실) ;
  • 김성훈 (연세대학교 원주의과대학 재활의학과학교실) ;
  • 김지현 (연세대학교 원주의과대학 재활의학과학교실) ;
  • 김오현 (연세대학교 원주의과대학 응급의학교실) ;
  • 김형일 (연세대학교 원주의과대학 응급의학교실) ;
  • 차경철 (연세대학교 원주의과대학 응급의학교실) ;
  • 이강현 (연세대학교 원주의과대학 응급의학교실) ;
  • 황성오 (연세대학교 원주의과대학 응급의학교실)
  • Youk, Hyun (Department of Emergency Medicine, Wonju College of Medicine, Yonsei University) ;
  • Cha, Yong Sung (Department of Emergency Medicine, Wonju College of Medicine, Yonsei University) ;
  • Kim, Hyun (Department of Emergency Medicine, Wonju College of Medicine, Yonsei University) ;
  • Kim, Sung Hoon (Department of Rehabilitation Medicine, Wonju College of Medicine, Yonsei University) ;
  • Kim, Ji Hyun (Department of Rehabilitation Medicine, Wonju College of Medicine, Yonsei University) ;
  • Kim, Oh Hyun (Department of Emergency Medicine, Wonju College of Medicine, Yonsei University) ;
  • Kim, Hyung Il (Department of Emergency Medicine, Wonju College of Medicine, Yonsei University) ;
  • Cha, Kyoung Chul (Department of Emergency Medicine, Wonju College of Medicine, Yonsei University) ;
  • Lee, Kang Hyun (Department of Emergency Medicine, Wonju College of Medicine, Yonsei University) ;
  • Hwang, Sung Oh (Department of Emergency Medicine, Wonju College of Medicine, Yonsei University)
  • 투고 : 2016.06.04
  • 심사 : 2016.08.12
  • 발행 : 2016.12.31
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초록

Purpose: Because carbon monoxide (CO)-intoxicated patients with an alert mental status and only mild cognitive dysfunction may be inadequately assessed by traditional bedside neurologic examination in the emergency department (ED), they may not receive appropriate treatment. Methods: We retrospectively investigated the incidence and features of cognitive dysfunction using the Korean version of the Mini-Mental State Examination (MMSE-K) in ED patients with CO poisoning with alert mental status. We conducted a retrospective review of 43 consecutive mild CO poisoned patients with a Glasgow Coma Scale score of 15 based on documentation by the treating emergency physician in the ED between July 2014 and August 2015. Results: Cognitive dysfunction, defined as a score of less than 24 in the MMSE-K, was diagnosed in six patients (14%) in the ED. In the MMSE-K, orientation to time, memory recall, and concentration/calculation showed greater impairments. The mean age was significantly older in the cognitive dysfunction group than the non-cognitive dysfunction group (45.3 yrs vs. 66.5 yrs, p<0.001). Among the initial symptoms, experience of a transient change in mental status before ED arrival was significantly more common in the cognitive dysfunction group (32.4% vs. 100%, p=0.003). Conclusion: Patients with CO poisoning and an alert mental status may experience cognitive dysfunction as assessed using the MMSE-K during the early stages of evaluation in the ED. In the MMSE-K, orientation to time, memory recall, and concentration/calculation showed the greatest impairment.

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참고문헌

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