Elmansy Alshaimma Mahmoud, Hannora Dalia Mustafa, Khalifa Heba K
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Medical colleges campus, 6 Floor, Al-Geish Street, Tanta University, Tanta, Elgharbya, 31527, Egypt.
Neuropsychiatry Department, Faculty of Medicine, Medical colleges campus, Al-Geish Street, Tanta University, Tanta, Elgharbya, 31527, Egypt.
Toxicol Res (Camb). 2024 Oct 7;13(5):tfae168. doi: 10.1093/toxres/tfae168. eCollection 2024 Oct.
Carbon monoxide (CO) poisoning is a major health problem associated with a high rate of severe morbidity and mortality.
This study aimed to evaluate the validity of the serum glucose/potassium (Glu/K) ratio as a quick predictor of both early and delayed unfavorable outcomes following acute CO poisoning.
This prospective cohort study included 136 patients with acute CO poisoning admitted at Tanta Poison Control Center, Egypt, between January 2023 and June 2024. The serum Glu/K ratio was calculated for all patients. The primary outcome was a prediction of mortality. Secondary outcomes were the prediction of delayed neurological sequelae (DNS) within six months after CO exposure, the need for mechanical ventilation, and the need for hyperbaric oxygen. A receiver operating curve analysis was applied to test the performance of the Glu/K ratio in predicting acute CO poisoning outcomes.
The mortality rate was 12.5% of patients with acute CO poisoning. Meanwhile, 14.7% of patients developed DNS. Furthermore, mechanical ventilation was required in 16.9% of patients. An elevated Glu/K ratio was significantly associated with the severity of acute CO poisoning. At a cut-off value of >31.62, the Glu/K ratio demonstrated an AUC of 0.649 for predicting mortality. The Glu/K ratio was employed to predict DNS at a cut-off value of 33.10, with a sensitivity of 60.0%, a specificity of 82.76%, and an AUC of 0.692.
Early Glu/K ratio may be an effective, reliable, and convenient laboratory predictor of mortality, DNS, and the need for mechanical ventilation in patients with acute CO poisoning.
一氧化碳（CO）中毒是一个严重的健康问题，与高发病率和死亡率相关。
本研究旨在评估血清葡萄糖/钾（Glu/K）比值作为急性CO中毒早期和延迟不良结局的快速预测指标的有效性。
这项前瞻性队列研究纳入了2023年1月至2024年6月期间在埃及坦塔中毒控制中心收治的136例急性CO中毒患者。计算所有患者的血清Glu/K比值。主要结局是预测死亡率。次要结局包括预测CO暴露后六个月内的延迟性神经后遗症（DNS）、机械通气需求以及高压氧需求。应用受试者工作特征曲线分析来测试Glu/K比值在预测急性CO中毒结局方面的性能。
急性CO中毒患者的死亡率为12.5%。同时，14.7%的患者出现了DNS。此外，16.9%的患者需要机械通气。Glu/K比值升高与急性CO中毒的严重程度显著相关。在临界值>31.62时，Glu/K比值预测死亡率的曲线下面积（AUC）为0.649。Glu/K比值在临界值为33.10时用于预测DNS，敏感性为60.0%，特异性为82.76%，AUC为0.692。
早期Glu/K比值可能是急性CO中毒患者死亡率、DNS以及机械通气需求的有效、可靠且便捷的实验室预测指标。
