Abstract
Objective
To explore the predictive value of neutrophil–lymphocyte ratio (NLR) at presentation for delayed neurological sequelae (DNS) in carbon monoxide (CO) poisoning.
Methods
This single-center retrospective observational study included a total of 253 consecutive patients who visited the emergency department (ED) due to acute CO intoxication between 7 October 2015 and 31 December 2019. The included patients had a history of coma and their blood routine was measured within one hour of ED admission. They were divided into two groups according to the presence of DNS, including those who developed DNS (DNS group) and those who did not (non-DNS group).
Results
A total of 171 patients were included in this research, and 49 (28.7%) developed DNS. The median NLR at ED admission was obviously higher in the DNS group (10.60 [9.69–15.34]) than in the non-DNS group (7.53 [5.86–8.56]) (p < 0.001). Multivariate analysis indicated that a high NLR (adjusted odds ratio (AOR): 1.78, 95% confidence interval (CI): 1.46–2.18) and the occurrence of acute brain lesions (AOR: 7.50, 95%CI: 2.86–19.68) on diffusion-weighted imaging were independent predictors of DNS. The NLR was more than 8.97. The prediction of occurrence of DNS had a sensitivity of 93.88% and a specificity of 84.43%. Kappa value was 0.713. The predicted results showed good authenticity and consistency.
Conclusion
The level of NLR at presentation had good predictive value for the development of DNS, showing the superior value for clinical application.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Data availability statement
The data that support the findings of this study are available from the corresponding author, Y. Z., upon reasonable request.