Serum bilirubin value predicts hospital admission in carbon monoxide-poisoned patients. Active player or simple bystander?
Clinics
;
70(9): 628-631, Sept. 2015. tab, ilus
Article
in English
| LILACS
| ID: lil-759288
ABSTRACT
OBJECTIVES:
Although carbon monoxide poisoning is a major medical emergency, the armamentarium of recognized prognostic biomarkers displays unsatisfactory diagnostic performance for predicting cumulative endpoints.METHODS:
We performed a retrospective and observational study to identify all patients admitted for carbon monoxide poisoning during a 2-year period. Complete demographical and clinical information, along with the laboratory data regarding arterial carboxyhemoglobin, hemoglobin, blood lactate and total serum bilirubin, was retrieved.RESULTS:
The study population consisted of 38 poisoned patients (23 females and 15 males; mean age 39±21 years). Compared with discharged subjects, hospitalized patients displayed significantly higher values for blood lactate and total serum bilirubin, whereas arterial carboxyhemoglobin and hemoglobin did not differ. In a univariate analysis, hospitalization was significantly associated with blood lactate and total serum bilirubin, but not with age, sex, hemoglobin or carboxyhemoglobin. The diagnostic performance obtained after combining the blood lactate and total serum bilirubin results (area under the curve, 0.90; 95% CI, 0.81-0.99; p<0.001) was better than that obtained for either parameter alone.CONCLUSION:
Although it remains unclear whether total serum bilirubin acts as an active player or a bystander, we conclude that the systematic assessment of bilirubin may, alongside lactate levels, provide useful information for clinical decision making regarding carbon monoxide poisoning.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Patient Admission
/
Bilirubin
/
Carbon Monoxide Poisoning
/
Lactic Acid
/
Endpoint Determination
Type of study:
Observational study
/
Prognostic study
/
Risk factors
Limits:
Adult
/
Female
/
Humans
/
Male
Language:
English
Journal:
Clinics
Journal subject:
Medicine
Year:
2015
Type:
Article
Affiliation country:
Italy
Institution/Affiliation country:
Academic Hospital of Parma/IT
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