Macro-CK in carbon monoxide poisoning: A guide for in-hospital mortality?

Carbon monoxide (CO) poisoning is common in developing countries and can be mortal. CO poisoning can present with various signs and symptoms. In addition, it has been observed that some people have increased cardiovascular diseases and are associated with high mortality. In this study, the usability of Macro creatine-kinase (Macro-CK) for in-hospital mortality detection in CO poisoning was investigated. This study is a retrospective and single-center study. Data of patients diagnosed with CO poisoning were accessed from the hospital automation system. Macro-CK was accepted for patients with CK-MB higher than total CK. The patients were divided into two groups according to the Macro-CK determination. Macro-CK detected patients were arranged as group-1, and the others as group-2. In-hospital mortality rates were determined in the groups and compared between groups and analyzed. 1100 patients were eligible for the study. Of these patients, Macro-CK was detected in 33 patients (0.03%). The mean age of the patients was 37.6 ± 16.9 and 43.2% were male. In-hospital mortality was 20 (60.6%) in group 1, and 50 (4.7%) in group 2 and was statistically significant (p<0.001). As a result of the regression analysis, it was determined that Macro-CK was statistically significant with in-hospital mortality (p=0.001). This result shows us that as the Macro-CK increases, the mortality also increases. Our study is the first study in the literature investigating the relationship between Macro-CK and mortality in CO poisoning. It is a study in which Macro-CK is determined as an independent predictor of in-hospital mortality.

[1]  M. Gladwin,et al.  A neuroglobin-based high-affinity ligand trap reverses carbon monoxide–induced mitochondrial poisoning , 2020, The Journal of Biological Chemistry.

[2]  O. Teksam,et al.  Evaluation of oxidative stress and antioxidant parameters in children with carbon monoxide poisoning , 2019, Human & experimental toxicology.

[3]  Chia-Hung Chen,et al.  Outcome and prognostic factors of patients treated in the intensive care unit for carbon monoxide poisoning. , 2019, Journal of the Formosan Medical Association = Taiwan yi zhi.

[4]  C. Simonsen,et al.  Carbon monoxide poisoning in Denmark with focus on mortality and factors contributing to mortality , 2019, PloS one.

[5]  Mei-Yi Wu,et al.  Treatment with normobaric or hyperbaric oxygen and its effect on neuropsychometric dysfunction after carbon monoxide poisoning , 2018, Medicine.

[6]  A. Kastrati,et al.  Creatine kinase myocardial band - a biomarker to assess prognostically relevant periprocedural myocardial infarction. , 2018, International journal of cardiology.

[7]  A. E. Kibar,et al.  Effects of Acute Carbon Monoxide Poisoning on ECG and Echocardiographic Parameters in Children , 2017, Cardiovascular Toxicology.

[8]  M. Gladwin,et al.  Carbon Monoxide Poisoning: Pathogenesis, Management, and Future Directions of Therapy , 2017, American journal of respiratory and critical care medicine.

[9]  Kun‐Lun Huang,et al.  Predicting poor outcome in patients with intentional carbon monoxide poisoning and acute respiratory failure: A retrospective study , 2015 .

[10]  B. Al,et al.  Therapeutic red cell exchange for severe carbon monoxide poisoning , 2013, Journal of clinical apheresis.

[11]  D. Davidson,et al.  Detection of creatine kinase macroenzymes , 2012, Annals of clinical biochemistry.

[12]  S. Wolf,et al.  Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department With Acute Carbon Monoxide Poisoning. , 2008, Annals of emergency medicine.

[13]  Christopher R Henry,et al.  Myocardial injury and long-term mortality following moderate to severe carbon monoxide poisoning. , 2006, JAMA.

[14]  T. Henry,et al.  Cardiovascular manifestations of moderate to severe carbon monoxide poisoning. , 2005, Journal of the American College of Cardiology.

[15]  P. Jacob,et al.  Cardiovascular effects of carbon monoxide and cigarette smoking. , 2001, Journal of the American College of Cardiology.

[16]  N B Hampson,et al.  Carbon monoxide poisoning--a public health perspective. , 2000, Toxicology.

[17]  G. Csako,et al.  Relevance of macro creatine kinase type 1 and type 2 isoenzymes to laboratory and clinical data. , 1994, Clinical chemistry.

[18]  C. Piantadosi,et al.  Mitochondrial oxidative stress after carbon monoxide hypoxia in the rat brain. , 1992, The Journal of clinical investigation.

[19]  S KAYE,et al.  Carbon monoxide poisoning. , 1957, Virginia medical monthly.

[20]  J. Ledingham,et al.  A rare but important cause for a raised serum creatine kinase concentration: two case reports and a literature review. , 2003, Rheumatology.