Serum bilirubin value predicts hospital admission in carbon monoxide-poisoned patients. Active player or simple bystander?

Authors

  • Gianfranco Cervellin Academic Hospital of Parma; Emergency Department
  • Ivan Comelli Academic Hospital of Parma; Emergency Department
  • Ruggero Buonocore Laboratory of Clinical Chemistry and Haematology, Academic Hospital of Parma
  • Alessandra Picanza Laboratory of Clinical Chemistry and Haematology, Academic Hospital of Parma
  • Gianni Rastelli Hospital of Vaio; Emergency Department
  • Giuseppe Lippi Laboratory of Clinical Chemistry and Haematology, Academic Hospital of Parma

DOI:

https://doi.org/10.6061/clinics/2015(09)06

Abstract

OBJECTIVES:Although carbon monoxide poisoning is a major medical emergency, the armamentarium of recognized prognostic biomarkers displays unsatisfactory diagnostic performance for predicting cumulative endpoints.METHODS:We performed a retrospective and observational study to identify all patients admitted for carbon monoxide poisoning during a 2-year period. Complete demographical and clinical information, along with the laboratory data regarding arterial carboxyhemoglobin, hemoglobin, blood lactate and total serum bilirubin, was retrieved.RESULTS:The study population consisted of 38 poisoned patients (23 females and 15 males; mean age 39±21 years). Compared with discharged subjects, hospitalized patients displayed significantly higher values for blood lactate and total serum bilirubin, whereas arterial carboxyhemoglobin and hemoglobin did not differ. In a univariate analysis, hospitalization was significantly associated with blood lactate and total serum bilirubin, but not with age, sex, hemoglobin or carboxyhemoglobin. The diagnostic performance obtained after combining the blood lactate and total serum bilirubin results (area under the curve, 0.90; 95% CI, 0.81-0.99; p<0.001) was better than that obtained for either parameter alone.CONCLUSION:Although it remains unclear whether total serum bilirubin acts as an active player or a bystander, we conclude that the systematic assessment of bilirubin may, alongside lactate levels, provide useful information for clinical decision making regarding carbon monoxide poisoning.

Downloads

Download data is not yet available.

Downloads

Published

2015-09-01

How to Cite

Cervellin, G., Comelli, I., Buonocore, R., Picanza, A., Rastelli, G., & Lippi, G. (2015). Serum bilirubin value predicts hospital admission in carbon monoxide-poisoned patients. Active player or simple bystander? . Clinics, 70(9), 628-631. https://doi.org/10.6061/clinics/2015(09)06

Issue

Section

Clinical Sciences