Background
Neurological sequelae | Cognitive and psychological sequelae |
---|---|
Parkinson-like syndromes | Concentration deficit |
Gait and motor disturbances | Memory loss |
Bradykinesia | Cognitive impairment |
Intention tremor | Dementia |
Myoclonus | Personality changes |
Dyspraxia | Anxiety |
Dysphasia | Extreme emotional lability |
Ataxia | Psychosis |
Postural instability | Depression |
Vertigo | Mania |
Cortical blindness | Insomnia |
Hearing loss, tinnitus | |
Chorea | |
EEG abnormalities | |
Epilepsy | |
Peripheral neuropathies | |
Recurrent headache | |
Fecal/urinay incontinence |
Methods
Statistical analysis
Results
Signs/symptoms in the Emergency Department | n = 347 | % |
---|---|---|
Headache | 203 | 58.5% |
Transient loss of consciousness | 142 | 40.9% |
Sinus tachycardia | 90 | 25.9% |
Nausea/vomiting | 87 | 25.0% |
Asthenia | 70 | 20.1% |
Dizziness | 70 | 20.1% |
Palpitations | 64 | 18.4% |
Evidence of myocardial injury | 60 | 17.2% |
GCS between 14 and 9 | 53 | 15.2% |
Postural instability | 37 | 10.6% |
GCS <9 | 29 | 8.3% |
Seizures | 24 | 6.9% |
Dyspnea | 22 | 6.3% |
Severe metabolic acidosis (pH <7.2) | 15 | 4.3% |
Cardiac chest pain | 6 | 1.7% |
Systolic blood pressure <90 mmHg | 6 | 1.7% |
Variables (before or upon ED admission) | Patient number = 141 mean ± SD | Non-DNS group at one month from hospital discharge (patient n = 107) mean ± SD | DNS group at one month from hospital discharge (patient n = 34) mean ± SD | p value |
---|---|---|---|---|
Age (years) | 42 ± 21 | 41.7 ± 21.7 | 40.4 ± 15.5 | >.05 |
Sex (male) | 64 (45.3%) | 53 (49.5%) | 11 (32.3%) | >.05 |
Duration of exposure >6 hours | 54 (38.2%) | 36 (33.6%) | 18 (52.9%) | .03 |
Suicide attempt | 5 (3.5%) | 3 (2.8%) | 2 (5.8%) | >.05 |
Hb (g/dL) | 14 ± 1.6 | 14.1 ± 1.16 | 13.7 ± 1.9 | >.05 |
WBC (per microlitre) | 9.87 ± 3.7 | 9.100 ± 2.900 | 11.900 ± 4.900 | .004 |
Plt (per microlitre) | 234.300 ± 58.300 | 236.000 ± 61.700 | 228.000 ± 47.000 | >.05 |
Troponin I (ng/mL) (n = 43) | 0.72 ± 3.25 | 0.88 ± 3.88 (n = 30) | 0.33 ± 0.66 (n = 13) | >.05 |
CPK (U/L) (n = 127) | 255 ± 763 | 159 ± 221 (n = 97) | 572 ± 1506 (n = 30) | .01 |
Lactate (mmol/L) (n = 82) | 1.77 ± 1.46 | 1.77 ± 1.41 (n = 62) | 1.76 ± 1.34 (n = 20) | >.05 |
pH | 7.41 ± 0.07 | 7.40 ± 0.07 | 7.41 ± 0.07 | >.05 |
paCO2 (KPa) | 4.78 ± 0.87 | 4.82 ± 0.89 | 4.62 ± 0.74 | >.05 |
paO2 (KPa) | 15.33 ± 1.09 | 14.93 ± 7.34 | 16.53 ± 10.45 | >.05 |
GCS <9 | 15 (10.6%) | 6 (5.6%) | 9 (26.4%) | .002 |
Transient loss of consciousness | 75 (53.1%) | 53 (49.5%) | 22 (64.7%) | >.05 |
Seizures | 14 (9.9%) | 5 (4.6%) | 9 (26.4%) | .001 |
Systolic blood pressure <90 mmHg | 4 (2.8%) | 1 (0.9%) | 3 (8.8%) | .04 |
Postural instability | 37 (26.2%) | 26 (24.2%) | 11 (32.3%) | >.05 |
Headache | 79 (56%) | 60 (56%) | 19 (55.8%) | >.05 |
GCS between 14 and 9 | 29 (20.5%) | 26 (24.2%) | 3 (8.8%) | >.05 |
Severe metabolic acidosis (pH <7.2) | 11 (7.8%) | 6 (5.6%) | 5 (14.7%) | >.05 |
Dyspnea | 6 (4.2%) | 4 (3.7%) | 2 (5.8%) | >.05 |
Mean carboxyhemoglobin level at admission (%) | 26.3 ± 10 | 26 ± 10.2 | 26.4 ± 10.5 | >.05 |
Evidence of myocardial injury | 33 (23.4%) | 23 (21,4%) | 10 (29,4%) | >.05 |
HBO therapy | 55 (39%) | 44 (41.1%) | 11 (32.3%) | >.05 |
Variables | Univariate analysis Odds ratio (confidence interval: 95%) | Multivariate analysis Odds ratio (confidence interval: 95%) |
---|---|---|
Systolic blood pressure <90 mmHg | 10.25 (1.40-73.68) | 1.34 (0.04-40.85) |
Seizures | 7.34 (2.53-22.28) | 1.65 (0.18-14.85) |
GCS <9 | 6.06 (2.04-17,95) | 7.15 (1.04-48.8) |
Leukocytosis (WBC >10.000/microlitre) | 3.13 (1.31-7.95) | 3.31 (1.02-10.71) |
Duration of exposure >6 hours | 2.13 (0.87-5.24) | 1.28 (0.09-2.9) |
CPK >160 U/L | 1.14 (0.49-2.60) | 1.02 (0.4-1.64) |
Variables (before or upon ED admission) | Patient number = 108 mean ± SD | OTI group (patient n = 55) mean ± SD | OTN group (patient n = 53) mean ± SD | p value |
---|---|---|---|---|
Age (years) | 44 ± 20 | 40.6 ± 20.4 | 48.2 ± 21.5 | >.05 |
Sex (male) | 50 (50.9%) | 23 (41.8%) | 27 (50.9%) | >.05 |
Duration of exposure > 6 hours | 41 (37.9%) | 27 (49.9%) | 14 (26.4%) | .01 |
Suicide attempt | 4 (3.7%) | 3 (5.4%) | 1 (1.8%) | >.05 |
Hb (g/dL) | 14 ± 1.7 | 13.8 ± 1.6 | 14 ± 1.8 | >.05 |
WBC (per microlitre) | 10.100 ± 3.890 | 10.300 ± 4.100 | 9.800 ± 3.500 | >.05 |
Plt (per microlitre) | 226.000 ± 50.000 | 220.100 ± 45.000 | 233.000 ± 54.300 | >.05 |
Troponin I (ng/mL) (n = 36) | 0.85 ± 3.54 | 0.98 ± 3.88 (n = 30) | 0.22 ± 0.44 (n = 6) | >.05 |
CPK (U/L) (n = 93) | 298 ± 867 | 385 ± 1149 (n = 50) | 195 ± 265 (n = 43) | >.05 |
Lactate (mmol/L) (n = 65) | 1.94 ± 1.6 | 2.05 ± 1.78 (n = 43) | 1.75 ± 1.1 (n = 22) | >.05 |
pH | 7.40 ± 0.08 | 7.41 ± 0.06 | 7.39 ± 0.1 | >.05 |
paCO2 (KPa) | 4.81 ± 0.94 | 4.73 ± 0.6 | 4.89 ± 1.21 | >.05 |
paO2 (KPa) | 15.8 ± 8.78 | 16.7 ± 8.0 | 14.7 ± 9.4 | >.05 |
GCS <9 | 15 (13.8%) | 9 (16.3%) | 6 (11.3%) | >.05 |
Transient loss of consciousness | 75 (69.4%) | 42 (76.3%) | 33 (62.2%) | >.05 |
Seizures | 14 (12.9%) | 12 (21.8%) | 2 (3.7%) | .008 |
Systolic blood pressure <90 mmHg | 4 (3.7%) | 1 (1.8%) | 3 (5.6%) | >.05 |
Postural instability | 32 (29.6%) | 14 (25.4%) | 18 (33.9%) | >.05 |
Headache | 54 (50%) | 31 (63.6%) | 23 (43.3%) | >.05 |
GCS between 14 and 9 | 29 (26.8%) | 14 (25.4%) | 15 (28.3%) | >.05 |
Severe metabolic acidosis (pH <7.2) | 11 (10.1%) | 5 (9%) | 6 (11.3%) | >.05 |
Dyspnea | 5 (4.6%) | 2 (3.6%) | 3 (5.6%) | >.05 |
Mean carboxyhemoglobin level at admission (%) | 27.7 ± 9.6 | 25.9 ± 9.41 | 29.5 ± 9.7 | >.05 |
Evidence of myocardial injury | 33 (30.5%) | 14 (25.4%) | 19 (35.8%) | >.05 |
DNS incidence at one month | 29 (26.8%) | 13 (23.6%) | 16 (30.1%) | >.05 |