Citation

Ku CH, Huang WH, Hsu CW, Chen YC, Hou YC, Wang IK, Hong HH, Wang YL, Weng CH, Yen TH. Int. J. Environ. Res. Public Health 2019; 16(22): e4426.

Copyright

(Copyright © 2019, MDPI: Multidisciplinary Digital Publishing Institute)

DOI

10.3390/ijerph16224426

PMID

31718107

PMCID

PMC6888208

Abstract

OBJECTIVE: This study examined predictors of globus pallidus necrosis as there was a paucity of literature of globus pallidus necrosis resulted from carbon monoxide poisoning after charcoal burning suicide.

METHODS: A total of 67 patients who had attempted charcoal burning suicide were recruited and stratified into two subgroups based on either presence (n = 40) or absence (n = 27) of globus pallidus necrosis. Demographic, clinical, laboratory, and radiographic data were obtained for cross-sectional analysis. All patients were followed to investigate the risks for mortality.

RESULTS: The patients aged 36.8 ± 11.1 years (67.2%) were male. Patients with globus pallidus necrosis were younger (p = 0.044) and had less hypertension (p = 0.015) than patients without globus pallidus necrosis. Furthermore, patients with globus pallidus necrosis suffered from severer medical complications, i.e., fever (p = 0.008), acute myocardial injury (p = 0.022), acute rhabdomyolysis (p = 0.022), and neuropsychiatric symptoms (p < 0.001) than patients without globus pallidus necrosis. Moreover, patients with globus pallidus necrosis received less hyperbaric oxygen therapy than without necrosis (p = 0.024). Two patients (3.0%) died on arrival. In a multivariable regression model, it was revealed that acute myocardial injury (odds ratio 4.6, confidence interval 1.1-18.9, p = 0.034) and neuropsychiatric symptoms (odds ratio 8.0, confidence interval 2.0-31.4, p = 0.003), decreased blood bicarbonate level (odds ratio 0.8, confidence interval 0.7-1.0, p = 0.032), and younger age (odds ratio 0.9, confidence interval 0.9-1.0, p = 0.038) were significant predictors for globus pallidus necrosis.

CONCLUSION: Although patients who had attempted charcoal burning suicide had a low mortality rate (3.0%), globus pallidus necrosis was not uncommon (59.7%) in this population. Further studies are warranted.

Language: en

Keywords

Humans; Cross-Sectional Studies; Adult; Aged; Female; Male; Middle Aged; Incidence; suicide; Odds Ratio; Carbon Monoxide Poisoning; Suicide, Attempted; mortality; Necrosis; Charcoal; charcoal burning; Globus Pallidus; globus pallidus necrosis