Clinical predictors of delayed neurological sequelae in charcoal-burning carbon monoxide poisoning

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dc.contributor.authorSert, Ekrem Taha
dc.contributor.authorKokulu, Kamil
dc.contributor.authorMutlu, Hüseyin
dc.date.accessioned2021-07-01T07:22:34Z
dc.date.available2021-07-01T07:22:34Z
dc.date.issued2021
dc.departmentTıp Fakültesi
dc.description.abstractBackground: The main objective of the treatment of acute carbon monoxide (CO) poisoning is to prevent delayed neurological sequelae (DNS). However, today there is still no objective screening tool to identify patients at high risk of developing DNS. The aim of this study was to identify clinical factors that could predict DNS after acute charcoal-burning CO poisoning. Methods: This prospective observational study was conducted from September 1, 2019 to August 31, 2020 in a single academic medical center. Patients older than 18 years of age suffering from charcoal-burning CO poisoning were included in the study. After acute recovery, patients were followed up for six weeks to investigate for DNS development. The clinical predictors of DNS were determined using a multivariate logistic regression model. Results: Of the 217 patients—113 males (52.1%), median age 37.0 (27.5–51.5) years—included, 49 (22.6%) developed DNS. The multivariate logistic regression analysis revealed the independent predictors of DNS as a lower initial Glasgow Coma Scale (GCS) score (adjusted odds ratio (AOR): 0.73, 95% confidence interval (CI): 0.62–0.87), a longer duration of CO exposure (AOR: 2.18, 95% CI: 1.65–2.88), and the presence of acute brain lesions with high signal intensity on diffusion-weighted imaging (AOR: 5.22, 95% CI: 1.50–18.08). The created multivariate regression model predicted DNS development with high accuracy (area under the curve: 0.93, 95% CI: 0.89–0.97). Conclusion: A low initial GCS score, longer exposure to CO and abnormal findings on diffusion-weighted magnetic resonance imaging can assist in the early identification of patients at high risk of DNS development.
dc.identifier.doi10.1016/j.ajem.2021.04.001
dc.identifier.endpage17en_US
dc.identifier.issn0735-6757
dc.identifier.pmid33838469
dc.identifier.scopusqualityQ1
dc.identifier.startpage12en_US
dc.identifier.urihttps:/dx.doi.org/10.1016/j.ajem.2021.04.001
dc.identifier.urihttps://hdl.handle.net/20.500.12451/8240
dc.identifier.volume48en_US
dc.identifier.wosWOS:000701895500003
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherW.B. Saunders
dc.relation.ispartofAmerican Journal of Emergency Medicine
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/embargoedAccess
dc.subjectCarbon Monoxide
dc.subjectCharcoal
dc.subjectDelayed Neurological Sequelae
dc.subjectNeurotoxicity
dc.subjectPoisoning
dc.titleClinical predictors of delayed neurological sequelae in charcoal-burning carbon monoxide poisoning
dc.typeArticle

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