Review of deaths cases due to carbon monoxide poisoning in a tertiary hospital

Abstract

Background: Carbon monoxide threatens its victims with sudden anoxic death and severe neurological sequelae. Materials and Methods: This is a descriptive and analytical retrospective study on 14 cases of deaths due to Carbon monoxide poisoning collected at the Forensic Department of Ibn Rochd University Hospital in Casablanca (UHC), over a two years period from January 2018 to December 2019. Results: Among the 14 deaths, there were nine (N=09) male victims (64%) and five (N=05) female (36%), aged 25 to 44 years in 43% of cases and 45 to 64 years in 36% of cases. Vast majority of cases (86%) involved accidental household poisoning. A water heater was incriminated in 36%. The source of Carbon monoxide was related to a defective device (36%). Neurological signs such as disturbances of consciousness were the most common (92%) symptom. The peak poisoning period (50%) occurred in December. Autopsy revealed pulmonary petechial spots (14%) and congestion of most organs. Carboxyhemoglobin (COHb) was positive in 8 cases with a rate> 5%, including 3 victims with no history of smoking and > 10% among 5 smokers. The value was negative for two victims who received oxygen therapy during hospital resuscitation efforts. The COHb level was indeterminable in 4 cases of which 3 victims were in advanced decomposition and one was exsanguinated. Conclusion: Prevention is key in reducing the morbidity and mortality of Carbon monoxide poisoning that can cause sudden anoxic death and severe neurological sequelae.