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

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 and Tzung-Hai Yen
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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
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

IJERPH, 2019, vol. 16, issue 22, 1-12

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.

Keywords: charcoal burning; suicide; globus pallidus necrosis; mortality (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
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