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Carbon Monoxide Poisoning, Myocardial Injury, and Mortality—Reply
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In Reply: Dr Chan inquires about fire exposure and cyanide poisoning in our cohort of patients with moderate to severe CO poisoning. In our series of 230 patients, 42 sustained CO poisoning from fire exposure and 12 (29%) had myocardial injury. By comparison, 188 patients were poisoned from other etiologies and 73 (39%) had myocardial injury. Only 1 patient had confirmed cyanide poisoning but cyanide levels were not systematically measured.
Drs Perez, Johnson-Arbor, and McKay raise an important question regarding clinical subgroups of patients described in our prior article.1 Only 47 of 81 patients with elevated biomarkers had echocardiograms. Of the patients with regional wall motion abnormalities, 7 (44% [95% confidence interval {CI}, 19%-68%]) of 16 died compared with 4 (29% [95% CI, 5%-52%]) of 14 with global dysfunction. In patients with neither regional nor global dysfunction, 8 (47% [95% CI, 23%-71%]) of 17 died. These percentages were not statistically . . . [Full Text of this Article]
Christopher R. Henry, BS
henry003@umn.edu
Minneapolis Heart Institute Foundation
Daniel Satran, MD
Department of Medicine
University of Minnesota
Bruce Lindgren, MS
University of Minnesota School of Public Health
Division of Biostatistics
Cheryl Adkinson, MD
Department of Emergency Medicine
Hennepin County Medical Center
Timothy D. Henry, MD
Minneapolis Heart Institute Foundation
Minneapolis, Minn
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