Predicting Poor Neurocognitive Outcomes in Acute Carbon Monoxide Poisoning

Annually, approximately 50,000 patients with carbon monoxide (CO) poisoning present to emergency departments (EDs) , with 1500 deaths. Approximately 15,000 intentional carbon monoxide poisonings annually account for more than two-thirds of reported deaths and cause neurocognitive sequelae among survivors.

Preventing neurocognitive sequelae is a major goal of treating acute carbon monoxide poisoning. There is a lack of reliable score systems for assessing the probability of these sequelae. A recent prognostic study developed and externally validated a prediction model including 5 risk factors associated with poor neurocognitive outcome at 1 month, creatine kinase level, hyperbaric oxygen therapy, Glasgow Coma Scale score, age, and shock cumulatively known as the COGAS score, among patients with carbon monoxide poisoning.

Findings of the study published in JAMA Network Open suggest that use of a reliable prediction model during the early phase of carbon monoxide poisoning could help identify patients at risk of poor neurocognitive sequelae.

Study included A total of 1282Participants aged 16 years or older admitted with CO poisoning. The outcome of interest was neurocognitive sequelae at 4 weeks after co poisoning.

Among 879 patients in the derivation cohort with 1-year follow-up data, 86.1% had unchanged scores, 11.6% had improved scores, and 2.3% had worsened scores.

Therefore, the authors concluded that assessing the COGAS score during the early phase of co poisoning may help identify patients at risk of poor neurocognitive sequelae.