1:2 matched case control study on risk factors of delayed encephalopathy after acute carbon monoxide poisoning

Abstract

Objective To explore the risk factors of the delayed encephalopathy after acute carbon monoxide poisoning (DEACMP). Methods 90 patients with DEACMP treated at our hospital from 2013 to 2018 were selected as case group. According to 1:2 matched case control study, 180 patients with acute CO poisoning but with no DEACMP who were treated at the department of neurology and emergency room of our hospital during the same time period were randomly selected as a control group. The risk factors were analyzed by univariate and multivariate analyses. Results The coma time, poisoning degree, complication with underlying diseases, and the CR/MRI findings of the brain were related to the occurrence of DEACMP. The risk of DEACMP in the patients with coma ≥4 h was 6.9 times that of those with coma <4 h; and the risk of the patients with severe poisoning was 3.8 times that of those with moderate; the longer the coma, the deeper the degree of poisoning, and the higher the incidence of DEACMP. Having underlying disease and abnormalities in head CT/MRI were also independent risk factors of DEACMP. Conclusions Patients with acute CO poisoning who have a long period of coma, deep poisoning, abnormal brain imaging, and underlying diseases should be highly valued. Hyperbaric oxygen therapy in a timely, early, and full course of treatment should be taken to reduce the incidence of DEACMP. Key words: Carbon monoxide poisoning; Delayed encephalopathy; Risk factors