 |
|
Myocardial Injury and Long-term Mortality Following Moderate to Severe Carbon Monoxide Poisoning
Christopher R. Henry, BS;
Daniel Satran, MD;
Bruce Lindgren, MS;
Cheryl Adkinson, MD;
Caren I. Nicholson, RN;
Timothy D. Henry, MD
JAMA. 2006;295:398-402.
Context Carbon monoxide (CO) poisoning is a common cause of toxicological morbidity and mortality. Myocardial injury is a frequent consequence of moderate to severe CO poisoning. While the in-hospital mortality for these patients is low, the long-term outcome of myocardial injury in this setting is unknown.
Objective To determine the association between myocardial injury and long-term mortality in patients following moderate to severe CO poisoning.
Design, Setting, and Participants Prospective cohort study of 230 consecutive adult patients treated for moderate to severe CO poisoning with hyperbaric oxygen and admitted to the Hennepin County Medical Center, a regional center for treatment of CO poisoning, between January 1, 1994, and January 1, 2002. Follow-up was through November 11, 2005.
Main Outcome Measure All-cause mortality.
Results Myocardial injury (cardiac troponin I level  0.7 ng/mL or creatine kinase-MB level 5.0 ng/mL and/or diagnostic electrocardiogram changes) occurred in 85 (37%) of 230 patients. At a median follow-up of 7.6 years (range: in-hospital only to 11.8 years), there were 54 deaths (24%). Twelve of those deaths (5%) occurred in the hospital as a result of a combination of burn injury and anoxic brain injury (n = 8) or cardiac arrest and anoxic brain injury (n = 4). Among the 85 patients who sustained myocardial injury from CO poisoning, 32 (38%) eventually died compared with 22 (15%) of 145 patients who did not sustain myocardial injury (adjusted hazard ratio, 2.1; 95% confidence interval, 1.2-3.7; P = .009).
Conclusion Myocardial injury occurs frequently in patients hospitalized for moderate to severe CO poisoning and is a significant predictor of mortality.
Author Affiliations: Minneapolis Heart Institute Foundation, Minneapolis, Minn (Mr C. Henry and Dr T. Henry); Departments of Internal Medicine (Drs Satran and T. Henry) and Emergency Medicine (Dr Adkinson and Ms Nicholson), Hennepin County Medical Center, Minneapolis, Minn; Department of Medicine, School of Medicine (Drs Satran and T. Henry) and Division of Biostatistics, School of Public Health (Mr Lindgren), University of Minnesota, Minneapolis; and Medical College of Wisconsin, Milwaukee (Mr C. Henry).
RELATED LETTERS
Carbon Monoxide Poisoning, Myocardial Injury, and Mortality
Gar Ming Chan
JAMA. 2006;295(22):2601.
EXTRACT
| FULL TEXT
Carbon Monoxide Poisoning, Myocardial Injury, and Mortality
Alberto Perez, Kelly Johnson-Arbor, and Charles A. McKay
JAMA. 2006;295(22):2601.
EXTRACT
| FULL TEXT
Carbon Monoxide Poisoning, Myocardial Injury, and Mortality—Reply
Christopher R. Henry, Daniel Satran, Bruce Lindgren, Cheryl Adkinson, and Timothy D. Henry
JAMA. 2006;295(22):2602.
EXTRACT
| FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Myocardial Fibrosis From Severe Carbon Monoxide Poisoning Detected by Cardiac Magnetic Resonance Imaging
Henry et al.
Circulation 2008;118:792-792.
FULL TEXT
Heart Disease Deaths among Firefighters
Duenas-Laita et al.
NEJM 2007;356:2535-2537.
FULL TEXT
Intravascular Neutrophil Activation Due to Carbon Monoxide Poisoning
Thom et al.
Am. J. Respir. Crit. Care Med. 2006;174:1239-1248.
ABSTRACT
| FULL TEXT
Environmental Cardiology: Studying Mechanistic Links Between Pollution and Heart Disease
Bhatnagar
Circ. Res. 2006;99:692-705.
ABSTRACT
| FULL TEXT
Neuroimaging, cognitive, and neurobehavioral outcomes following carbon monoxide poisoning.
Hopkins and Woon
Behav Cogn Neurosci Rev 2006;5:141-155.
ABSTRACT
Carbon monoxide poisoning, myocardial injury, and mortality.
Chan
JAMA 2006;295:2601-2601.
FULL TEXT
Carbon Monoxide Poisoning, Myocardial Injury, and Mortality--Reply
Henry et al.
JAMA 2006;295:2602-2602.
FULL TEXT
Carbon monoxide poisoning, myocardial injury, and mortality.
Perez et al.
JAMA 2006;295:2601-2601.
FULL TEXT
Myocardial Injury from CO Poisoning Increases Mortality Risk
JWatch Emergency Med. 2006;2006:6-6.
FULL TEXT
JournalScan
Malik
Heart 2006;92:575-576.
FULL TEXT
Myocardial Injury and Carbon Monoxide Poisoning
Journal Watch Cardiology 2006;2006:6-6.
FULL TEXT
What's new in the other general journals
Tonks
BMJ 2006;332:289-290.
FULL TEXT
|
