Monthly variations in the diagnosis of carbon monoxide exposures in the emergency department
Partrick, M.; Fiesseler, F.; Shih, R.; Riggs, R.; Hung, O.
Undersea and Hyperbaric Medicine Journal of the Undersea and Hyperbaric Medical Society Inc 36(3): 161-167
2009
ISSN/ISBN: 1066-2936 PMID: 19860138 Document Number: 632466
Carbon monoxide (CO) poisoning is the leading cause of toxicological deaths worldwide. Symptoms may be subtle, contributing to its frequent delay in diagnosis. If a seasonal variation occurs, a heightened awareness during peak time may lead to improved recognition and diagnosis. To determine whether monthly variations in CO poisoning occur in emergency departments. A multicenter retrospective emergency department (ED) cohort. 23 New Jersey and New York emergency departments. Consecutive patients with the ICD-9 primary diagnosis of"toxic effects CO" from January 1, 2000 to October 31, 2006. We tested for significant differences using chi-square and Student's t-test with alpha set at 0.5. There were 1,006 patients who were diagnosed in the ED with CO toxicity (0.024% of all ED patients). Mean age was 30 years (SD +/- 20), 54% were female, and Caucasians compromised 54% of participants. Thirty-nine percent of documented patients arrived via ambulance and 90% were subsequently discharged. Incidence of CO visits peaked in December (0.036%) and were least likely in May (0.011%). Mean monthly CO visits were statistically increased during October (p = < 0.0001), November (p = 0.008), December (< 0.0001), January (p = 0.01), and March (p = 0.04). Statistically fewer case of CO exposure were diagnosed in May (p = 0.0003), June (p = 0.005), August (p = < 0.0001), and September (p = 0.002).