Journal of The Korean Society of Emergency Medicine (대한응급의학회지)

The Korean Society of Emergency Medicine (대한응급의학회)
권호 표지

Long-term outcome of delayed neuropsychiatric sequelae after carbon monoxide poisoning

일산화탄소중독에서 지연신경정신장애의 장기적인 예후

  • Yoo, Joo Young (Department of Emergency Medicine, Dankook University College of Medicine) ;
  • Kim, Gap Teog (Department of Emergency Medicine, Dankook University College of Medicine) ;
  • Koh, Chan Young (Department of Emergency Medicine, Dankook University College of Medicine)
  • 유주영 (단국대학교 의과대학 응급의학교실) ;
  • 김갑득 (단국대학교 의과대학 응급의학교실) ;
  • 고찬영 (단국대학교 의과대학 응급의학교실)
  • Received : 2018.06.05
  • Accepted : 2018.08.28
  • Published : 2018.10.31

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Abstract

Objective: Delayed neuropsychiatric sequelae (DNS) following carbon monoxide (CO) poisoning, which may result from a demyelinating leukoencephalopathy, is a disease with a poor prognosis. This study examined the factors affecting the long-term prognosis of DNS and the efficacy of hyperbaric oxygen therapy (HBOT) in patients with DNS. Methods: This retrospective study included 84 patients with DNS following CO poisoning from January 2013 to June 2016. HBOT was given to 24 patients. The patients were divided into an improvement group and non-improvement group based on their clinical condition on a telephone interview at intervals between 3 months and 3 years after the onset of DNS. The improvement group was defined as having Cerebral Performance Category (CPC) scores in their daily life that improve to 1 or 2 grade. Results: Of the 594 patients, DNS were found in 18.2%, and 70.2% (59 of 84) of the patients with DNS improved. The prognostic factors for the improvement of DNS were an age of 45 years or less (odds ratio [OR], 12.068; 95% confidence interval [CI], 2.393-60.858; P<0.005), CPC score of 1 or 2 group at the time of DNS onset (OR, 12.361; 95% CI, 3.161-48.330; P<0.005), and a lucid interval longer than 20 days (OR, 5.164; 95% CI, 1.393-19.141; P<0.01). HBOT was not associated with the improvement of DNS in CO poisoning (OR, 0.467; 95% CI, 0.172-1.269; P>0.1). Conclusion: Patients aged less than 45 years, low grade CPC score of 1 and 2, and lucid interval longer than 20 days are more likely to have a good prognosis. On the other hand, HBOT failed to produce a benefit for DNS patients.

Keywords

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