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急性一氧化碳中毒患者高压氧治疗时间与迟发性神经后遗症的相关性

Correlation between Time to Hyperbaric Oxygen Therapy and Delayed Neurological Sequelae in Acute Carbon Monoxide Poisoning Patients.

作者信息

Choi Sungwoo, Nah Sangun, Han Sangsoo

机构信息

Department of Emergency Medicine, Soonchunhyang University Bucheon Hospital, Bucheon 14584, Republic of Korea.

出版信息

Diagnostics (Basel). 2024 Jan 15;14(2):186. doi: 10.3390/diagnostics14020186.

Abstract

Carbon monoxide (CO) is one of the most common causes of intoxication. Delayed neurologic sequelae (DNS) have a major impact on prognosis of CO poisoning patients. Hyperbaric oxygen therapy (HBOT) is widely used to treat DNS. However, there is no consensus regarding the optimal timing of HBOT. This prospective study enrolled patients who visited the hospital from November 2019 to October 2022. The cutoff value for the latency to HBOT after CO exposure was determined, and the area under the receiver operating characteristic curve (AUC) was estimated. In total, 167 patients were divided into non-DNS and DNS groups. The initial Glasgow Coma Scale (GCS) score, CO exposure time, latency to HBOT after CO exposure, median length of hospital stay ( < 0.001) and creatine kinase ( = 0.016) showed significant differences. A GCS score ≤ 9 had an odds ratio (OR) of 5.059 (95% confidence interval [CI]: 1.602-15.976, = 0.006), and latency to HBOT after CO exposure ≥ 200 min had an OR of 18.971 (95% CI: 4.310-83.508, < 0.001). The AUC was 0.8235 (95% CI: 0.7504-0.8966). A GCS score ≤ 9 and latency to HBOT ≥ 200 min may be significant risk factors for DNS.

摘要

一氧化碳(CO)是中毒最常见的原因之一。迟发性神经后遗症(DNS)对CO中毒患者的预后有重大影响。高压氧治疗(HBOT)被广泛用于治疗DNS。然而,关于HBOT的最佳时机尚无共识。这项前瞻性研究纳入了2019年11月至2022年10月期间到医院就诊的患者。确定了CO暴露后至HBOT的延迟时间的临界值,并估计了受试者工作特征曲线(AUC)下的面积。总共167例患者被分为非DNS组和DNS组。初始格拉斯哥昏迷量表(GCS)评分、CO暴露时间、CO暴露后至HBOT的延迟时间、中位住院时间(<0.001)和肌酸激酶(=0.016)显示出显著差异。GCS评分≤9的优势比(OR)为5.059(95%置信区间[CI]:1.602-15.976,=0.006),CO暴露后至HBOT的延迟时间≥200分钟的OR为18.971(95%CI:4.310-83.508,<0.001)。AUC为0.8235(95%CI:0.7504-0.8966)。GCS评分≤9和HBOT延迟时间≥200分钟可能是DNS的重要危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce1a/10814448/ac5d9184c79b/diagnostics-14-00186-g001.jpg

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