Abstract
Background
Acute brain lesions on diffusion-weighted-magnetic resonance imaging (MRI) after acute
carbon monoxide (CO) poisoning were associated with delayed neurological sequelae.
This study was conducted to identify the risk factors associated with acute brain
lesions on MRI after acute CO poisoning and to help select patients who need acute-phase
brain MRI after acute CO poisoning in the emergency department (ED).
Methods
This retrospective observational study included 103 adult patients who were hospitalized
at a tertiary-care hospital between November 2016 and September 2019 and underwent
brain MRI because of acute CO poisoning. Multivariable logistic regression analysis
was applied to identify predictive factors for acute brain lesions on MRI after acute
CO poisoning.
Results
Multivariable logistic regression analysis showed that Glasgow Coma Scale (GCS) score
of <9 at ED presentation (odds ratio [OR] 17.749, 95% confidence interval [CI] 3.098–101.690,
P = 0.001) and the initial troponin-I level at presentation in the ED (OR 13.657, 95%
CI 1.415–131.834, P = 0.024) were predictive factors for acute brain lesions on MRI in acute CO poisoning.
The receiver operating characteristics curve for initial troponin-I showed an area
under the curve of 0.761 (95% CI 0.638–0.883, P < 0.001) and the optimal cutoff value was 0.105 ng/mL.
Conclusions
Acute-phase brain MRI in acute CO poisoning can be considered for patients who present
at the ED with a GCS score <9 or troponin-I level >0.105 ng/mL.
Abbreviations:
DW-MRI (diffusion-weighted-magnetic resonance imaging), ED (emergency department), CO (carbon monoxide), GCS (Glasgow Coma Scale), OR (odds ratio), CI (confidence interval), ROC (receiver operating characteristics), AUC (area under the curve), HBOT (hyperbaric oxygen therapy)Keywords
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Article Info
Publication History
Published online: May 27, 2020
Accepted:
May 22,
2020
Received in revised form:
May 22,
2020
Received:
April 2,
2020
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
