Glasgow coma scale may be a predictive factor for delayed neurological sequelae after carbon monoxide poisoning: a retrospective analysis of a nationwide multicenter observational registry in Japan.

IF 1.8 4区 医学 Q4 TOXICOLOGY
Tadashi Kaneko, Motoki Fujita, Ryosuke Tsuruta
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引用次数: 0

Abstract

Acute carbon monoxide poisoning (ACOP) is a cause of accidental or deliberate deaths worldwide. Subsequent complications, particularly delayed neurological sequelae (DNS), are preventable and treatable based on their pathophysiology. Hyperbaric oxygenation therapy (HBO) is a potential procedure for preventing and treating DNS; however, the effects of HBO on DNS are unclear and debated. In the present study, we investigated which factors are associated with the development of DNS and the effects of HBO in patients with ACOP. We performed retrospective subanalyses of the COP-J registry, focusing on adults who underwent HBO, regardless of whether they developed DNS. The multivariable analysis showed that the Glasgow coma scale (GCS) on admission was significantly associated with DNS (odds ratio 0.736; 95% confidence interval 0.608-0.892; P = 0.002). The receiver operating characteristic curve analysis of GCS for DNS revealed a cutoff value of 12.5 according to Youden's index (sensitivity 80.8%, specificity 76.9%). This retrospective analysis of a nationwide Japanese registry of ACOP showed that low GCS scores on admission could be a predictive factor for DNS, with a possible cutoff value of ≤12, in patients who undergo HBO.

格拉斯哥昏迷量表可能是一氧化碳中毒后迟发性神经系统后遗症的预测因素:一项对日本全国多中心观察登记的回顾性分析。
急性一氧化碳中毒(ACOP)是世界范围内意外或故意死亡的原因。随后的并发症,特别是迟发性神经系统后遗症(DNS),根据其病理生理学是可以预防和治疗的。高压氧治疗(HBO)是预防和治疗DNS的潜在方法;然而,HBO对DNS的影响尚不清楚且存在争议。在本研究中,我们探讨了哪些因素与ACOP患者发生DNS和HBO的影响相关。我们对COP-J登记进行了回顾性亚分析,重点是接受HBO治疗的成年人,无论他们是否发展为DNS。多变量分析显示入院时格拉斯哥昏迷评分(GCS)与DNS显著相关(优势比0.736;95%置信区间0.608-0.892;P = 0.002)。GCS对DNS的受试者工作特征曲线分析显示,根据约登指数(Youden's index),截断值为12.5(敏感性80.8%,特异性76.9%)。这项对日本全国ACOP登记的回顾性分析显示,入院时GCS评分低可能是接受HBO治疗的患者发生DNS的预测因素,临界值可能≤12。
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来源期刊
CiteScore
3.20
自引率
5.00%
发文量
53
审稿时长
4-8 weeks
期刊介绍: The Journal of Toxicological Sciences (J. Toxicol. Sci.) is a scientific journal that publishes research about the mechanisms and significance of the toxicity of substances, such as drugs, food additives, food contaminants and environmental pollutants. Papers on the toxicities and effects of extracts and mixtures containing unidentified compounds cannot be accepted as a general rule.
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