Risk Factors Associated with Rhabdomyolysis in Acute Carbon Monoxide Poisoning

PURPOSE: The aim of this study was to determine the risk factors for rhabdomyolysis in patients with carbon monoxide (CO) poisoning. METHODS: This was a retrospective study on patients with CO poisoning who visited the emergency department from January 1, 2014 to December 31, 2015. We compared clinical variables between patients with and without rhabdomyolysis. RESULTS: Among 120 patients who were included to this study, 108 patients exhibited normal value of CPK (creatine phosphokinase), and 12 patients were diagnosed as rhabdomyolysis. Sources of CO, duration of CO exposure, initial GCS (Grasgow coma scale), initial systolic and diastolic blood pressure, initial body temperature and AKI (Acute kidney injury) were showed significant difference between patients who developed rhabdomyolysis and patients who did not. In addition, initial white blood cell counts, troponin I level and carboxyhemoglobin (COHb) level were more higher in rhabdomyolysis group. pH and initial bicarbonate level were more lower. Duration of CO exposure (Odds ratio, 1.011; 95% confidence interval, 1.002∼1.020, P=0.021)was found to be only risk factor for rhabdomyolysis by logistic regression analysis. CONCLUSION: Duration of CO exposure is potential risk factor of rhabdomyolysis development in CO poisoning.

The Effect of Brain Hemorrhage on the Prognosis of Out-of-Hospital Cardiac Arrest: a Retrospective Study

PURPOSE: Spontaneous intracranial hemorrhage (ICH) is not an uncommon cause of cardiac arrest. The purpose of this study was to identify the prognosis of patients with ICH for Out-of-Hospital Cardiac arrest (OHCA). METHODS: From January 2008 to December 2010, a total of 214 patients were checked brain computed tomography (CT) in OHCA. The majority of patients were male (136, 63.8%), and the median age was 55.0 (+/-16.7). We included all patients who were checked through brain CT for non-traumatic OHCA. Data were collected from electronic medical records and pre-hospital records. Demographic, clinical and laboratory data were compared between the ICH and non-ICH group. RESULTS: The detection of ICH by clinical manifestations and laboratory data was difficult. Out of 214 patients, 21 (9.8%) patients were positive for ICH and 193(90.2%) patients had a normal brain CT. In demographic and clinical data, the neurological outcome (CPC score, p=0.009) and 30-day survival rate (p<0.001) were statistically different between the two groups. Using the Cox proportional hazards model, the ICH group had a 3.54 hazard ratio compared with non-ICH group. In addition, pH (p=0.033), lactate (p=0.023) in ABGA, potassium (p=0.008), glucose (p=0.026), and S-100 (p=0.047) showed significant results. CONCLUSION: The prognosis of ICH patients in OHCA is poor; further studies are needed to improve the prognosis of ICH patients after ROSC in OHCA.