Carbon Monoxide Poisoning in Geriatric Patients

老年人一氧化碳中毒

10.29461/TGG.201408_9(3).0003

高元(Yuan Kao)；鄒建芳(Jian-Fang Zou)；蔡岡廷(Kang-Ting Tsai)；陳炳仁(Ping-Jen Chen)；林宏榮(Hung-Jung Lin)；許建清(Chien-Chin Hsu)；郭浩然(How-Ran Guo)；蘇世斌(Shih-Bin Su)；黃建程(Chien-Cheng Huang)

一氧化碳 ； 老年 ； 神經學後遺症 ； 預測因子 ； carbon monoxide ； geriatric ； neurological sequelae ； predictor

台灣老年醫學暨老年學雜誌

9卷3期（2014 / 08 / 01）

84 - 95

英文

目的：隨著社會老化，老年人一氧化碳中毒的問題也開始被重視。然而，老年人一氧化碳中毒不曾被研究過。因此，我們進行本研究來釐清這議題。方法：我們在中國山東省收集1990年到2011年老年一氧化碳中毒病人的資料來分析。結果：我們共收集了88位病人資料,發現有高達59%的病人有神經學後遺症。常見中毒的症狀有：暫時喪失意識、意識改變、頭暈、失禁、噁心嘔吐、出現Babinski's reflex、頭痛及無瞳孔反應。暫時喪失意識是正向的神經學後遺症預測因子，相反的，頭痛是負向預測因子。結論：本研究呈現了老年一氧化碳中毒的臨床表現，並找出獨立神經學後遺症的預測因子，以提供臨床醫師重要的參考。

Objectives: In response to the continuous growth in the elderly population, the problem of carbon monoxide poisoning (COP) in the elderly, a hitherto understudied issue, is begnning to receive deserved attention. The study accordingly aimed at delineating the clinical characteristics of COP and identifying predictors of neurological sequelae in geriatric patients with COP. Methods: This retrospective study was conducted at four hospitals in Shandong Province, China. Data were collected from patients with COP between November 1990 and October 2011. Thirty-day neurological sequelae were the primary endpoints. Results: Eighty-eight geriatric patients were identified; 59% had neurological sequelae; initial manifestations of COP included loss of consciousness (69.3%), altered mental status (44.3%), dizziness (39.8%), incontinence (37.5%), nausea/vomiting (34.1%), positive for Babinski's reflex (22.7%), headache (20.5%), and absent pupil reflex (9.1%). Multiple logistic regression analysis showed that age was not predictive, while loss of consciousness was a positive (OR: 11.4; 95% CI: 3.4-37.5) and headache a negative (OR: 0.2; 95% CI: 0.1-0.7) predictor. Conclusion: This study delineates the clinical characteristics and two independent predictors of neurological sequelae for geriatric patients with COP. These are important references for clinical practice and may help physicians make decisions in the treatment and prognosis of geriatric patients with COP.