Retrospective analysis of cases diagnosed with carbon monoxide poisoning in Kırşehir province

Retrospective Analysis of Cases Diagnosed with Carbon Monoxide Poisoning in Kırşehir Province Objective: In this study, we performed a retrospective analysis of the cases diagnosed with carbon monoxide poisoning in Kırşehir Training and Research Hospital in the last 5 (five) years. We analysed the sociodemographic characteristics, blood parameters, ECG findings, complaints at presentation, medical history, and hyperbaric treatment status of the patients. We investigated the effect of blood COHB level on blood parameters and ECG. We also statistically analysed the time of presentation and the distribution of poisonings according to years. We aimed to find out the effect of carbon monoxide poisoning on the blood picture and ECG of the patients and whether different blood parameters other than COHB level can be used for diagnosis. Method: This study was conducted on patients who were diagnosed with carbon monoxide poisoning in the emergency department of Kırşehir Training and Research Hospital between 2018 and 2023 and referred from the districts with the diagnosis of CO poisoning and is a retrospective descriptive speciality thesis research. The study included 317 patients with complete data. Results: Data of 317 patients diagnosed with CO poisoning who were admitted to Kırşehir Training and Research Hospital and referred from district hospitals were included in the study. The youngest patient was 1 year old and the oldest patient was 89 years old. The mean age of the patients was 33.85∓23.16 years. It was found that the patients diagnosed with poisoning were mostly admitted between 09-12 hours (64 people), most of the admissions were in winter months and the most common complaint was headache (n:140- 25.8%). Of the patients diagnosed, 259 (75.95%) had no history of the disease. In 58(24.05%) patients, at least 1 chronic disease was detected in the history. 159(50.3%) of the patients were treated as outpatients and discharged. 69(21.8%) patients were hospitalised in the ward, 41(12.93%) patients were hospitalised in intensive care unit and 47(14.8%) patients were hospitalised in paediatric ward. 4(1.3%) out of 317 patients died. 43(13.6%) patients received hyperbaric oxygen treatment and 274(86.4%) patients received normobaric O2 treatment. Of the patients who received hyperbaric oxygen therapy, 90.7% were hospitalised and 9.3% were discharged after HBOT. A significant positive correlation was found between COHB level and Troponin in poisoning cases admitted to the emergency department (Rho=0.963**, p=0.000). A significant positive correlation was found between COHB level and CK (Rho=0.989**, p=0.000). A significant positive correlation was found between COHB level and CK-MB (Rho=0.965**, p=0.000). COHB levels of patients who received hyperbaric treatment were found to be higher than those who did not receive hyperbaric treatment. This difference between the patients who received hyperbaric treatment and the patients who did not receive hyperbaric treatment was statistically significant (p=0.000). COHB levels of the cases who died were found to be higher than those who survived. This difference between the cases who died and the survivors was statistically significant (p=0.002). COHb level had significant effects on ECG. COHb level was 9.20 (7.20~12.20) in normal sinus rhythm, 18.10 (12.40~25.20) in sinus tachycardia, 25.10 (13.82~37.92) in St depression and 15.80 (10.70~21.22) in T negativity (p:0.000). Conclusion: According to the results obtained from this study, COHb level affects cardiac markers and ECG findings. As the severity of poisoning increases, deterioration in laboratory parameters increases. The gold standard diagnostic test of carbon monoxide poisoning is the measurement of COHb level. Cardiac markers and lactate level analysed from blood gas may indicate the clinical severity of CO poisoning cases. Further studies are needed for alternative blood parameters that can be used in CO poisoning. Key words: Carbon monoxide poisoning, CO, COHb, NBOT, HBOT, ECG findings of CO poisoning, effect of COHb level on clinical findings, effect of CO on cardiac markers