Call for Follow-Up in Manitowoc, WI Carbon Monoxide Case

A Manitowoc, WI carbon monoxide case sent 17 people to the hospital, four of which were treated with hyperbaric oxygen treatment. Each year, more than 400 people die from unintentional, non-fire related carbon monoxide poisoning, according to the Centers for Disease Control and Prevention statistics. More than 20,000 visit the emergency room for the same reason, and more than 4,000 are hospitalized.

In one study by Neil Hampson, Rose Rudd, and Niels Hauff, published in Critical Care Medicine in 2009, results demonstrated increased risk of long-term mortality after carbon monoxide poisoning. The study participants were a retrospective cohort of people treated for acute carbon monoxide poisoning at Hyperbaric Medicine of Virginia Mason Medical Center in Seattle, WA from May 1978 through December 2005. There were 1,502 cases during this time, but people younger than 18 were excluded.

In total, 1,073 patients treated with hyperbaric oxygen were included in the study. Although guidelines for this treatment have evolved, in general people treated with hyperbaric oxygen had moderate to severe carbon monoxide poisoning. This was indicated by transient or prolonged unconsciousness, abnormal neurologic findings on exam, cardiac ischemia, or carboxyhemoglobin levels greater than 25 to 30 percent.

The mortality of the group of patients were compared to a standard population. The expected number of deaths in this group was 87. The actual number of deaths were 162 subjects, 75 higher than expected. The risk of long-term mortality was greater in the intentional poisoning group with 58 excess deaths. In the group of accidental poisonings, there were 17 excess deaths. The major causes of death were mental and psychiatric disorders, injuries, and violence.

While mortality was greater in the intentional group, all-cause mortality was significantly elevated in both groups of patients exposed from 18 to 45 years old. Therefore, whether the poisoning was intentional or not, medical follow-up should be executed closely after discharge from the hospital. Medical professionals should give psychiatric or neurocognitive examinations as appropriate. This holds true in the Manitowoc, WI carbon monoxide case. Close medical follow-up should be given to these patients after discharge.