Cha et al identified risk factors for myocardial injury associated with carbon monoxide poisoning. The presence of significant myocardial injury is associated with a worse prognosis. The authors are fro Yonsei University in Wonju City, Korea.
Patient selection: carbon monoxide poisoning
Myocardial injury was identified by elevation of serum troponin I concentration. The peak occurs around 11 hours after poisoning. Approximately 20% of patients in their study showed evidence of myocardial injury.
Risk factors for myocardial injury:
(1) male gender (odds ratio 3.3)
(2) Glasgow coma score (GCS) <= 14 (odds rato 9.9)
(3) carbon monoxide poisoning time >= 2 hours (odds ratio 7.7)
number of risk factors =
= SUM(number of risk factors present)
cumulative hazard ratio for myocardial injury =
= PRODUCT(hazard ratios for risk factors present)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 3
• The risk of myocardial injury increases with the number of risk factors.
• The presence of significant myocardial injury was associated with a worse prognosis.
