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

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  • Chung-Hsuan Ku

    (Department of Nephrology, Clinical Poison Center, Kidney Research Center, Center for Tissue Engineering, Chang Gung Memorial Hospital, Chang Gung University, Linkou 333, Taiwan)

  • Wen-Hung Huang

    (Department of Nephrology, Clinical Poison Center, Kidney Research Center, Center for Tissue Engineering, Chang Gung Memorial Hospital, Chang Gung University, Linkou 333, Taiwan)

  • Ching-Wei Hsu

    (Department of Nephrology, Clinical Poison Center, Kidney Research Center, Center for Tissue Engineering, Chang Gung Memorial Hospital, Chang Gung University, Linkou 333, Taiwan)

  • Yu-Chin Chen

    (Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
    Department of Psychology, University of Arizona, Tuscon, AZ 85721, USA)

  • Yi-Chou Hou

    (Division of Nephrology, Department of Internal Medicine, Cardinal Tien Hospital, School of Medicine, Fu-Jen Catholic University, New Taipei City 23155, Taiwan)

  • I-Kuan Wang

    (Department of Nephrology, China Medical University Hospital, China Medical University, Taichung 40402, Taiwan)

  • Hsiang-Hsi Hong

    (Department of Periodontics, Chang Gung Memorial Hospital, Chang Gung University, Linkou 333, Taiwan)

  • Yen-Li Wang

    (Department of Periodontics, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan 333, Taiwan)

  • Cheng-Hao Weng

    (Department of Nephrology, Clinical Poison Center, Kidney Research Center, Center for Tissue Engineering, Chang Gung Memorial Hospital, Chang Gung University, Linkou 333, Taiwan)

  • Tzung-Hai Yen

    (Department of Nephrology, Clinical Poison Center, Kidney Research Center, Center for Tissue Engineering, Chang Gung Memorial Hospital, Chang Gung University, Linkou 333, Taiwan)

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.

Suggested Citation

  • 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, 2019. "Incidence Rate and Predictors of Globus Pallidus Necrosis after Charcoal Burning Suicide," IJERPH, MDPI, vol. 16(22), pages 1-12, November.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:22:p:4426-:d:285978
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    References listed on IDEAS

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    1. Chung-Shun Wong & Ying-Chin Lin & Li-Chin Sung & Tzu-Ting Chen & Hon-Ping Ma & Yung-Ho Hsu & Shin-Han Tsai & Yuh-Feng Lin & Mei-Yi Wu, 2017. "Increased long-term risk of major adverse cardiovascular events in patients with carbon monoxide poisoning: A population-based study in Taiwan," PLOS ONE, Public Library of Science, vol. 12(4), pages 1-9, April.
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