Increased long-term mortality among survivors of acute carbon monoxide poisoning
OBJECTIVE:Recent data suggest that patients surviving acute carbon monoxide (CO) poisoning (COP) may have increased risk for long-term mortality. The objective of this study was to analyze long-term mortality of a large population of CO-poisoned patients treated at one medical center over three deca...
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| Veröffentlicht in: | Critical care medicine 2009-06, Vol.37 (6), p.1941-1947 |
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| container_end_page | 1947 |
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| container_issue | 6 |
| container_start_page | 1941 |
| container_title | Critical care medicine |
| container_volume | 37 |
| creator | Hampson, Neil B Rudd, Rose Anne Hauff, Niels M |
| description | OBJECTIVE:Recent data suggest that patients surviving acute carbon monoxide (CO) poisoning (COP) may have increased risk for long-term mortality. The objective of this study was to analyze long-term mortality of a large population of CO-poisoned patients treated at one medical center over three decades.
DESIGN:Retrospective cohort study of patients treated with hyperbaric oxygen and surviving the acute poisoning episode. Long-term mortality was compared to a standard population. Comparison of mortality within the cohort by clinical indicators of poisoning severity was assessed using Cox proportional hazards regression analysis.
SETTING:Regional referral center for hyperbaric treatment of COP.
PATIENTS:One thousand seventy-three patients aged ≥18 years treated from 1978 to 2005.
INTERVENTIONS:All patients received hyperbaric oxygen treatment.
MEASUREMENTS AND MAIN RESULTS:During 11,741 person-years of follow-up, 162 subjects died. The expected number of deaths was 87 (standardized mortality ratio [SMR]), 1.9; 95% confidence interval [CI], 1.6–2.2). Most of the excess mortality was in the group treated initially for intentional COP (58 excess deaths; SMR, 3.7; 95% CI, 2.9–4.6) vs. those treated for accidental COP (17 excess deaths; SMR, 1.3; 95% CI, 1.01–1.6). For the entire cohort, the major causes of death with significantly raised mortality were mental and psychiatric disorders, injuries, and violence. More specific causes of death with significantly raised mortality were alcoholism, motor vehicle accidents with pedestrians, motor vehicle accidents of unspecified type, accidental poisonings, and intentional self-harm. Within cohort comparisons showed that no difference in survival was observed by measure of CO poisoning severity, after controlling for age at poisoning, sex, race, and intent of CO poisoning.
CONCLUSIONS:Adult survivors of acute CO poisoning treated with hyperbaric oxygen were at increased risk for long-term mortality. Such patients should be followed closely after discharge with consideration given to psychiatric and/or neurocognitive evaluation, as appropriate. |
| doi_str_mv | 10.1097/CCM.0b013e3181a0064f |
| format | Article |
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DESIGN:Retrospective cohort study of patients treated with hyperbaric oxygen and surviving the acute poisoning episode. Long-term mortality was compared to a standard population. Comparison of mortality within the cohort by clinical indicators of poisoning severity was assessed using Cox proportional hazards regression analysis.
SETTING:Regional referral center for hyperbaric treatment of COP.
PATIENTS:One thousand seventy-three patients aged ≥18 years treated from 1978 to 2005.
INTERVENTIONS:All patients received hyperbaric oxygen treatment.
MEASUREMENTS AND MAIN RESULTS:During 11,741 person-years of follow-up, 162 subjects died. The expected number of deaths was 87 (standardized mortality ratio [SMR]), 1.9; 95% confidence interval [CI], 1.6–2.2). Most of the excess mortality was in the group treated initially for intentional COP (58 excess deaths; SMR, 3.7; 95% CI, 2.9–4.6) vs. those treated for accidental COP (17 excess deaths; SMR, 1.3; 95% CI, 1.01–1.6). For the entire cohort, the major causes of death with significantly raised mortality were mental and psychiatric disorders, injuries, and violence. More specific causes of death with significantly raised mortality were alcoholism, motor vehicle accidents with pedestrians, motor vehicle accidents of unspecified type, accidental poisonings, and intentional self-harm. Within cohort comparisons showed that no difference in survival was observed by measure of CO poisoning severity, after controlling for age at poisoning, sex, race, and intent of CO poisoning.
CONCLUSIONS:Adult survivors of acute CO poisoning treated with hyperbaric oxygen were at increased risk for long-term mortality. Such patients should be followed closely after discharge with consideration given to psychiatric and/or neurocognitive evaluation, as appropriate.</description><identifier>ISSN: 0090-3493</identifier><identifier>EISSN: 1530-0293</identifier><identifier>DOI: 10.1097/CCM.0b013e3181a0064f</identifier><identifier>PMID: 19384195</identifier><identifier>CODEN: CCMDC7</identifier><language>eng</language><publisher>Hagerstown, MD: by the Society of Critical Care Medicine and Lippincott Williams & Wilkins</publisher><subject>Acute Disease ; Adult ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Carbon Monoxide Poisoning - mortality ; Carbon Monoxide Poisoning - therapy ; Cause of Death ; Cohort Studies ; Drug intoxications. Doping ; Female ; Humans ; Hyperbaric Oxygenation ; Intensive care medicine ; Male ; Medical sciences ; Pharmacology. Drug treatments ; Retrospective Studies ; Survival Rate ; Time Factors</subject><ispartof>Critical care medicine, 2009-06, Vol.37 (6), p.1941-1947</ispartof><rights>2009 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins</rights><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3807-ad3fc4a45d15425986f62aa37aa0c774af14280d0a8c9be48b960192e3ecc9983</citedby><cites>FETCH-LOGICAL-c3807-ad3fc4a45d15425986f62aa37aa0c774af14280d0a8c9be48b960192e3ecc9983</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21500876$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19384195$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hampson, Neil B</creatorcontrib><creatorcontrib>Rudd, Rose Anne</creatorcontrib><creatorcontrib>Hauff, Niels M</creatorcontrib><title>Increased long-term mortality among survivors of acute carbon monoxide poisoning</title><title>Critical care medicine</title><addtitle>Crit Care Med</addtitle><description>OBJECTIVE:Recent data suggest that patients surviving acute carbon monoxide (CO) poisoning (COP) may have increased risk for long-term mortality. The objective of this study was to analyze long-term mortality of a large population of CO-poisoned patients treated at one medical center over three decades.
DESIGN:Retrospective cohort study of patients treated with hyperbaric oxygen and surviving the acute poisoning episode. Long-term mortality was compared to a standard population. Comparison of mortality within the cohort by clinical indicators of poisoning severity was assessed using Cox proportional hazards regression analysis.
SETTING:Regional referral center for hyperbaric treatment of COP.
PATIENTS:One thousand seventy-three patients aged ≥18 years treated from 1978 to 2005.
INTERVENTIONS:All patients received hyperbaric oxygen treatment.
MEASUREMENTS AND MAIN RESULTS:During 11,741 person-years of follow-up, 162 subjects died. The expected number of deaths was 87 (standardized mortality ratio [SMR]), 1.9; 95% confidence interval [CI], 1.6–2.2). Most of the excess mortality was in the group treated initially for intentional COP (58 excess deaths; SMR, 3.7; 95% CI, 2.9–4.6) vs. those treated for accidental COP (17 excess deaths; SMR, 1.3; 95% CI, 1.01–1.6). For the entire cohort, the major causes of death with significantly raised mortality were mental and psychiatric disorders, injuries, and violence. More specific causes of death with significantly raised mortality were alcoholism, motor vehicle accidents with pedestrians, motor vehicle accidents of unspecified type, accidental poisonings, and intentional self-harm. Within cohort comparisons showed that no difference in survival was observed by measure of CO poisoning severity, after controlling for age at poisoning, sex, race, and intent of CO poisoning.
CONCLUSIONS:Adult survivors of acute CO poisoning treated with hyperbaric oxygen were at increased risk for long-term mortality. Such patients should be followed closely after discharge with consideration given to psychiatric and/or neurocognitive evaluation, as appropriate.</description><subject>Acute Disease</subject><subject>Adult</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Carbon Monoxide Poisoning - mortality</subject><subject>Carbon Monoxide Poisoning - therapy</subject><subject>Cause of Death</subject><subject>Cohort Studies</subject><subject>Drug intoxications. Doping</subject><subject>Female</subject><subject>Humans</subject><subject>Hyperbaric Oxygenation</subject><subject>Intensive care medicine</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Pharmacology. Drug treatments</subject><subject>Retrospective Studies</subject><subject>Survival Rate</subject><subject>Time Factors</subject><issn>0090-3493</issn><issn>1530-0293</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkd9LwzAQx4Mobk7_A5G--Jh5adI2eZThj8FEH_S5XNN0q7bNSNrN_fdmbCh4cBx3fL938DlCrhlMGajsbjZ7mUIBjBvOJEOAVFQnZMwSDhRixU_JGEAB5ULxEbnw_hOAiSTj52TEFJeCqWRM3uaddga9KaPGdkvaG9dGrXU9NnW_i7ANw8gPblNvrPORrSLUQ28ija6wXVB29rsuTbS2tbdd3S0vyVmFjTdXxzohH48P77Nnunh9ms_uF1RzCRnFkldaoEhKlog4UTKt0hiRZ4igs0xgxUQsoQSUWhVGyEKlwFRsuNFaKcknRBz2ame9d6bK165u0e1yBvkeUB4A5f8BBdvNwbYeitaUf6YjkSC4PQrQa2wqh52u_a8uZgmAzNK_-1vbBGj-qxm2xuUrg02_yiEEj0VK4_0P0tDRkCzjP4ZCf6s</recordid><startdate>200906</startdate><enddate>200906</enddate><creator>Hampson, Neil B</creator><creator>Rudd, Rose Anne</creator><creator>Hauff, Niels M</creator><general>by the Society of Critical Care Medicine and Lippincott Williams & Wilkins</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>200906</creationdate><title>Increased long-term mortality among survivors of acute carbon monoxide poisoning</title><author>Hampson, Neil B ; Rudd, Rose Anne ; Hauff, Niels M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3807-ad3fc4a45d15425986f62aa37aa0c774af14280d0a8c9be48b960192e3ecc9983</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Acute Disease</topic><topic>Adult</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Carbon Monoxide Poisoning - mortality</topic><topic>Carbon Monoxide Poisoning - therapy</topic><topic>Cause of Death</topic><topic>Cohort Studies</topic><topic>Drug intoxications. Doping</topic><topic>Female</topic><topic>Humans</topic><topic>Hyperbaric Oxygenation</topic><topic>Intensive care medicine</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Pharmacology. Drug treatments</topic><topic>Retrospective Studies</topic><topic>Survival Rate</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hampson, Neil B</creatorcontrib><creatorcontrib>Rudd, Rose Anne</creatorcontrib><creatorcontrib>Hauff, Niels M</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Critical care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hampson, Neil B</au><au>Rudd, Rose Anne</au><au>Hauff, Niels M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Increased long-term mortality among survivors of acute carbon monoxide poisoning</atitle><jtitle>Critical care medicine</jtitle><addtitle>Crit Care Med</addtitle><date>2009-06</date><risdate>2009</risdate><volume>37</volume><issue>6</issue><spage>1941</spage><epage>1947</epage><pages>1941-1947</pages><issn>0090-3493</issn><eissn>1530-0293</eissn><coden>CCMDC7</coden><abstract>OBJECTIVE:Recent data suggest that patients surviving acute carbon monoxide (CO) poisoning (COP) may have increased risk for long-term mortality. The objective of this study was to analyze long-term mortality of a large population of CO-poisoned patients treated at one medical center over three decades.
DESIGN:Retrospective cohort study of patients treated with hyperbaric oxygen and surviving the acute poisoning episode. Long-term mortality was compared to a standard population. Comparison of mortality within the cohort by clinical indicators of poisoning severity was assessed using Cox proportional hazards regression analysis.
SETTING:Regional referral center for hyperbaric treatment of COP.
PATIENTS:One thousand seventy-three patients aged ≥18 years treated from 1978 to 2005.
INTERVENTIONS:All patients received hyperbaric oxygen treatment.
MEASUREMENTS AND MAIN RESULTS:During 11,741 person-years of follow-up, 162 subjects died. The expected number of deaths was 87 (standardized mortality ratio [SMR]), 1.9; 95% confidence interval [CI], 1.6–2.2). Most of the excess mortality was in the group treated initially for intentional COP (58 excess deaths; SMR, 3.7; 95% CI, 2.9–4.6) vs. those treated for accidental COP (17 excess deaths; SMR, 1.3; 95% CI, 1.01–1.6). For the entire cohort, the major causes of death with significantly raised mortality were mental and psychiatric disorders, injuries, and violence. More specific causes of death with significantly raised mortality were alcoholism, motor vehicle accidents with pedestrians, motor vehicle accidents of unspecified type, accidental poisonings, and intentional self-harm. Within cohort comparisons showed that no difference in survival was observed by measure of CO poisoning severity, after controlling for age at poisoning, sex, race, and intent of CO poisoning.
CONCLUSIONS:Adult survivors of acute CO poisoning treated with hyperbaric oxygen were at increased risk for long-term mortality. Such patients should be followed closely after discharge with consideration given to psychiatric and/or neurocognitive evaluation, as appropriate.</abstract><cop>Hagerstown, MD</cop><pub>by the Society of Critical Care Medicine and Lippincott Williams & Wilkins</pub><pmid>19384195</pmid><doi>10.1097/CCM.0b013e3181a0064f</doi><tpages>7</tpages></addata></record> |
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| ispartof | Critical care medicine, 2009-06, Vol.37 (6), p.1941-1947 |
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| source | MEDLINE; Journals@Ovid Complete |
| subjects | Acute Disease Adult Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Carbon Monoxide Poisoning - mortality Carbon Monoxide Poisoning - therapy Cause of Death Cohort Studies Drug intoxications. Doping Female Humans Hyperbaric Oxygenation Intensive care medicine Male Medical sciences Pharmacology. Drug treatments Retrospective Studies Survival Rate Time Factors |
| title | Increased long-term mortality among survivors of acute carbon monoxide poisoning |
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