PAUL S. HECKERLING, M.D.; JERROLD B. LEIKIN, M.D.; ANDREW MATUREN, Ph.D.; JAMES T. PERKINS, M.D.
Headache and dizziness occur at carboxyhemoglobin levels of greater than 10%. We studied 89 patients with headache or dizziness for evidence of carbon monoxide exposure. The mean carboxyhemoglobin level was 2.87%. Number of cigarettes smoked per day (r = 0.471; p < 0.00002), use of gas kitchen stoves for heating purposes (r = 0.252, p < 0.02), problems with the home heating system (r = 0.278, p < 0.01), and cohabitants with concurrent headache or dizziness (r = 0.427, p < 0.01) correlated with carboxyhemoglobin levels. Multiple regression analysis identified number of cigarettes smoked daily, use of stoves for heat, and concurrently symptomatic cohabitants as significant predictors of carboxyhemoglobin level (F = 13.939 [3, 85]; p < 0.01). Obtaining carboxyhemoglobin levels from patients who used stoves for heat or had similarly affected cohabitants identified 4 of 4 patients with levels greater than 10% (sensitivity, 100%) and excluded 47 of 85 patients with lower levels (specificity, 55.3%). The 4 patients with carboxyhemoglobin levels in excess of 10% may represent occult carbon monoxide poisoning in this population.
HECKERLING PS, LEIKIN JB, MATUREN A, PERKINS JT. Predictors of Occult Carbon Monoxide Poisoning in Patients with Headache and Dizziness. Ann Intern Med. ;107:174–176. doi: 10.7326/0003-4819-107-2-174
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Published: Ann Intern Med. 1987;107(2):174-176.
Emergency Medicine, Headache, Neurology.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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