Incidence Rate and Predictors of Globus Pallidus Necrosis after Charcoal Burning Suicide.

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.

• Authors: Chung-Hsuan Ku, Wen-Hung Huang, Ching-Wei Hsu, Yu-Chin Chen, Yi-Chou Hou, I-Kuan Wang, Hsiang-Hsi Hong, Yen-Li Wang, Cheng-Hao Weng, Tzung-Hai Yen
• Journal: International journal of environmental research and public health (Int J Environ Res Public Health) Vol. 16 Issue 22 (11 12 2019) ISSN: 1660-4601 [Electronic] Switzerland
• PMID: 31718107 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Charcoal

Topics

• Adult
• Aged
• Carbon Monoxide Poisoning (mortality)
• Charcoal (adverse effects)
• Cross-Sectional Studies
• Female
• Globus Pallidus (pathology)
• Humans
• Incidence
• Male
• Middle Aged
• Necrosis
• Odds Ratio
• Suicide, Attempted