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HOME > J Korean Soc Clin Toxicol > Volume 14(2); 2016 > Article
Incidence and Features of Cognitive Dysfunction Identified by Using Mini-mental State Examination at the Emergency Department among Carbon Monoxide-poisoned Patients with an Alert Mental Status
Hyun Youk, Yong Sung Cha, Hyun Kim, Sung Hoon Kim, Ji Hyun Kim, Oh Hyun Kim, Hyung Il Kim, Kyoung Chul Cha, Kang Hyun Lee, Sung Oh Hwang
Journal of The Korean Society of Clinical Toxicology 2016;14(2):115-121
DOI: https://doi.org/10.22537/jksct.2016.14.2.115
Published online: December 31, 2016
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1Department of Emergency Medicine, Wonju College of Medicine, Yonsei University
10Department of Emergency Medicine, Wonju College of Medicine, Yonsei University
2Department of Emergency Medicine, Wonju College of Medicine, Yonsei University
3Department of Emergency Medicine, Wonju College of Medicine, Yonsei University
4Department of Rehabilitation Medicine, Wonju College of Medicine, Yonsei University
5Department of Rehabilitation Medicine, Wonju College of Medicine, Yonsei University
6Department of Emergency Medicine, Wonju College of Medicine, Yonsei University
7Department of Emergency Medicine, Wonju College of Medicine, Yonsei University
8Department of Emergency Medicine, Wonju College of Medicine, Yonsei University
9Department of Emergency Medicine, Wonju College of Medicine, Yonsei University

Purpose: Because carbon monoxide (CO)-intoxicated patients with an alert mental status and only mild cognitive dysfunction may be inadequately assessed by traditional bedside neurologic examination in the emergency department (ED), they may not receive appropriate treatment. Methods: We retrospectively investigated the incidence and features of cognitive dysfunction using the Korean version of the Mini-Mental State Examination (MMSE-K) in ED patients with CO poisoning with alert mental status. We conducted a retrospective review of 43 consecutive mild CO poisoned patients with a Glasgow Coma Scale score of 15 based on documentation by the treating emergency physician in the ED between July 2014 and August 2015. Results: Cognitive dysfunction, defined as a score of less than 24 in the MMSE-K, was diagnosed in six patients (14%) in the ED. In the MMSE-K, orientation to time, memory recall, and concentration/calculation showed greater impairments. The mean age was significantly older in the cognitive dysfunction group than the non-cognitive dysfunction group (45.3 yrs vs. 66.5 yrs, p<0.001). Among the initial symptoms, experience of a transient change in mental status before ED arrival was significantly more common in the cognitive dysfunction group (32.4% vs. 100%, p=0.003). Conclusion: Patients with CO poisoning and an alert mental status may experience cognitive dysfunction as assessed using the MMSE-K during the early stages of evaluation in the ED. In the MMSE-K, orientation to time, memory recall, and concentration/calculation showed the greatest impairment.

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