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The Importance of Magnetic Resonance Imaging Findings and Serum Carboxy hemoglobin Levels in the Prediction of Late Neuropsychosis in Carbon Monoxide Poisoning

Author(s): Figen Turkdogan

The effects of carbon monoxide poisoning(CO) on the central nervous system in the late period after discharge are still controversial. The aim was to evaluate late stage neuropsychosis (NP) findings of carbon monoxide with serum carboxyhemoglobin (COHb) levels and magnetic resonance imaging (MRI) findings. Of the 363 patients who applied to emergency service due to CO between January 2017 and December 2014 were included in this retrospective study. The patients who had a COHb level higher than 5% and those who underwent MRI in the acute-subacute period were followed for 60 months and their development states were recorded. Mean age of the patients was 49.2 ± 8.2 years, 123 (33.9%) were female, and approximate follow-up time was 60 months. Neuropsychosis symptoms were found in 33 (17.3%) of the 363 patients followed. Carboxyoglobin level and exposure time to CO were found to be higher in cases with neuropsychosis and MRI groups III and IV (p=0.001). NP and mortality were most frequent in MRI group IV (p=0.001). In addition, serum COHb level was found to be low in MRI groups I and II, while it was found to be high in groups III and IV (p=0.004). In the correlation of MRI groups with the variables, moderate and strong positive correlation was found with NP (r=0.684), serum COHb level (r=0.889), mortality (r=0.274), CO exposure time (r=0.425) (p=0.001). Mortality rate was found to be higher in MRI group IV, in patients with a COHb level higher than 56.8% and in male patients. In late periodneuropsychosis prediction of carbon monoxide poisoning, serum carboxyhemoglobin levels and MRI findings may be helpful values in the risk prediction. 

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