Risk Factors for Delayed Neuropsychiatric Sequelae in Carbon Monoxide Poisoning: Ten Years' Experience in a Pediatric Emergency Department

Objective: The occurrence of Delayed Neuropsychiatric Sequelae (DNS) after Carbon Monoxide (CO) poisoning is uncommon in children. Early identification of risk factors for the development of DNS in pediatric emergency departments is important. The objective of this study was to analyze risk factors for DNS after CO poisoning. Methods: We retrospectively analyzed children with CO poisoning admitted to the pediatric emergency department from 2001 to 2010. Clinical, demographic, and laboratory data were collected; chi-square and univariate analyses were performed to assess risk factors for DNS. Results: Among 68 children with CO poisoning, seven (10.3%) developed DNS. Clinical parameters such as Glasgow Coma Scales (GCS), Methemohemoglobin (MetHb), troponin-I, CPK level, myocardial injury, and neuroimaging abnormalities, were important associated risk factors for DNS. Decreased GCS level (OR = 0.701) and Methemohemoglobin (MetHb) ≥ 0.8% (OR = 19.54) are associated with DNS. Carboxyhemoglobin, and inadequate HBO therapy were not risk factor. Conclusions: Prompt treatment of CO poisoning and identify risk factor for DNS is still challenge in PED. Our data demonstrate that decreased GCS level and increased MetHb level were independent risk factors associated with DNS. Early recognition and prompt treatment is important to prevent further neurological damage.