Predictive value of cardiovascular risk scoring systems for the detection of myocardial injury following carbon monoxide intoxication


Özkoç M., Aksakal E., Derman Ö. F., Saraç İ., KOZA Y.

Turkish Journal of Emergency Medicine, cilt.23, sa.1, ss.30-37, 2023 (ESCI) identifier identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 23 Sayı: 1
  • Basım Tarihi: 2023
  • Doi Numarası: 10.4103/2452-2473.366483
  • Dergi Adı: Turkish Journal of Emergency Medicine
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.30-37
  • Anahtar Kelimeler: Carbon monoxide poisoning, cardiotoxicity, cardiovascular risk, myocardial injury
  • Atatürk Üniversitesi Adresli: Evet

Özet

© 2023 Emergency Medicine Association of Turkey. All rights reserved.OBJECTIVES: This single-center, retrospective study investigates the predictive value of cardiovascular (CV) risk-calculation systems in patients admitted to the emergency department with carbon monoxide (CO) intoxication for the identification of potential myocardial injury. METHODS: The total CV risk of 558 patients presenting to the emergency department with CO intoxication were calculated on admission using different CV risk scoring systems, including SCORE Turkey, European Heart SCORE, and FRAMINGHAM to predict potential myocardial injury secondary to poisoning, and the risk levels were categorized based on the calculated scores. The presence of myocardial injury was identified based on the level of elevation of a cardiac biomarker (Serum cardiac troponin-I >99thpercentile upper reference limit). RESULTS: Myocardial injury due to CO intoxication was detected in 132 (23.7%) of the patients. A comparison of the risk scoring systems' ability to detect the presence of myocardial injury revealed that all had significant, similar, but low predictive values (the 'area under the curve' values of SCORE Turkey, European Heart SCORE and FRAMINGHAM were 0.653, 0.632, and 0.629, respectively; P < 0.001). Among the three risk scoring systems, SCORE Turkey was the most successful test in diagnosing myocardial injury with 87% specificity, while FRAMINGHAM scoring was the most successful test in excluding the presence of myocardial injury with 72.1% sensitivity. CONCLUSION: Among the tested CV risk-calculation systems SCORE Turkey, was found to be the most effective in the prediction of myocardial injury secondary to CO poisoning, but all produced similar and significant results.