Onda Hidetaka, Nishino Takuya, Kojima Mizuki, Miyake Nodoka, Shigeta Kenta, Tominaga Naoki, Yokobori Shoji
Department of Disaster and Emergency Medicine, Kochi University, 185-1 Oko-cho, Nankoku, Kochi, 7838505, Japan.
Department of Health Care Administration, Nippon Medical School, Tokyo, Japan.
Sci Rep. 2025 Apr 25;15(1):14491. doi: 10.1038/s41598-025-98162-1.
Carbon monoxide (CO) poisoning causes significant mortality and hypoxic brain injury. Hyperbaric oxygen therapy (HBOT) may reduce delayed neurological sequelae, but poor outcomes persist. A model for predicting outcomes early after hospital admission is crucial for guiding care and early rehabilitation. In this study, we aimed to develop a clinical scoring model to predict poor outcomes in acute CO poisoning cases. The study included 176 patients aged ≥ 15 years with acute CO poisoning who were transported for HBOT between 2012 and 2023, after excluding those aged < 15 years and those in cardiac arrest on arrival. Acute CO poisoning was defined as CO exposure or COHb > 5% (> 10% for smokers). HBOT involved ≥ 1 session at 2.8 absolute atmospheres for 60 min. Predictors of poor outcomes included age, GCS < 13, burns and low C-reactive protein levels. The ABCG score (age, burns, CRP, GCS) demonstrated strong discriminative ability, with an area under the ROC curve of 0.917, sensitivity of 0.852 and specificity of 0.828. The ABCG score accurately predicts poor outcomes in acute CO poisoning and supports early intervention and treatment planning. External validation and broader application are needed for clinical adoption.
一氧化碳（CO）中毒会导致显著的死亡率和缺氧性脑损伤。高压氧治疗（HBOT）可能会减少延迟性神经后遗症，但仍有不良后果。建立一个入院后早期预测预后的模型对于指导护理和早期康复至关重要。在本研究中，我们旨在开发一种临床评分模型，以预测急性CO中毒病例的不良预后。该研究纳入了2012年至2023年间因急性CO中毒接受高压氧治疗、年龄≥15岁的176例患者，排除了年龄<15岁以及入院时心脏骤停的患者。急性CO中毒定义为接触CO或碳氧血红蛋白（COHb）>5%（吸烟者>10%）。高压氧治疗包括在2.8绝对大气压下进行≥1次60分钟的治疗。不良预后的预测因素包括年龄、格拉斯哥昏迷量表（GCS）评分<13、烧伤和低C反应蛋白水平。ABCG评分（年龄、烧伤、C反应蛋白、GCS）显示出很强的鉴别能力，ROC曲线下面积为0.917，敏感性为0.852，特异性为0.828。ABCG评分能够准确预测急性CO中毒的不良预后，并支持早期干预和治疗规划。临床应用需要进行外部验证和更广泛的应用。
