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Open AccessArticle

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

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Department of Nephrology, Clinical Poison Center, Kidney Research Center, Center for Tissue Engineering, Chang Gung Memorial Hospital, Chang Gung University, Linkou 333, Taiwan
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Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
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Department of Psychology, University of Arizona, Tuscon, AZ 85721, USA
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Division of Nephrology, Department of Internal Medicine, Cardinal Tien Hospital, School of Medicine, Fu-Jen Catholic University, New Taipei City 23155, Taiwan
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Department of Nephrology, China Medical University Hospital, China Medical University, Taichung 40402, Taiwan
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Department of Periodontics, Chang Gung Memorial Hospital, Chang Gung University, Linkou 333, Taiwan
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Department of Periodontics, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan 333, Taiwan
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Authors to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(22), 4426; https://doi.org/10.3390/ijerph16224426
Received: 10 October 2019 / Revised: 8 November 2019 / Accepted: 11 November 2019 / Published: 12 November 2019
(This article belongs to the Special Issue Burden of Disease Attributable to Air Pollution)
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. View Full-Text
Keywords: charcoal burning; suicide; globus pallidus necrosis; mortality charcoal burning; suicide; globus pallidus necrosis; mortality
MDPI and ACS Style

Ku, C.-H.; Huang, W.-H.; Hsu, C.-W.; Chen, Y.-C.; Hou, Y.-C.; Wang, I.-K.; Hong, H.-H.; Wang, Y.-L.; Weng, C.-H.; Yen, T.-H. Incidence Rate and Predictors of Globus Pallidus Necrosis after Charcoal Burning Suicide. Int. J. Environ. Res. Public Health 2019, 16, 4426.

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