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J Korean Soc Emerg Med > Volume 25(3); 2014 > Article
Journal of The Korean Society of Emergency Medicine 2014;25(3): 261-267.
Predicting Factors for the Development of Rhabdomyolysis in the Carbon Monoxide Poisoning
Jae Hawng Im, Seok Ran Yeom, Sang Kyoon Han, Sung Hwa Lee, Soon Chang Park, Suck Joo Cho, Sung Wook Park
Department of Emergency Medicine, Pusan National University Hospital, Busan, Korea. psu52156@naver.com
ABSTRACT
PURPOSE:
Carbon monoxide (CO) poisoning can cause rhabdomyolysis and acute kidney injury (AKI). However, until recently, studies regarding CO-induced rhabdomyolysis were rarely reported. This study was conducted in order to determine the risk factors for prediction of development of CO-induced rhabdomyolysis.
METHODS:
We retrospectively reviewed the medical records of 70 CO poisoned patients who presented to an emergency department from January 2010 to December 2012. CO poisoning related parameters, patient demographics, and laboratory data were analyzed.
RESULTS:
Rhabdomyolysis and AKI were observed in 11 patients (15.7%) and six (8.6%) patients, respectively. Time of exposure to CO, age, Glasgow coma scale, and leukocyte count differed significantly between patients who developed rhabdomyolysis and patients who did not. Exposure time to CO was the only risk factor for predicting development of rhabdomyolysis (odds ratio, 1.365; 95% confidence interval, 1.014-1.836; p=0.040).
CONCLUSION:
The frequency of rhabdomyolysis in CO poisoning was 15.7% and fluid therapy was very effective in treatment of CO-induced rhabdomyolysis and prevention of AKI progression. An exposure time to CO of over 5 hours was a factor with high potential for predicting development of CO-induced rhabdomyolysis. Along with patients' symptoms and signs, this factor should be considered in assessment of patients with CO poisoning.
Key words: Carbon monoxide, Rhabdomyolysis, Acute kidney injury
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