A scoring system with high predictive performance for poor outcomes in acute carbon monoxide poisoning

Abstract 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 re...

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Main Authors: Hidetaka Onda, Takuya Nishino, Mizuki Kojima, Nodoka Miyake, Kenta Shigeta, Naoki Tominaga, Shoji Yokobori
Format: Article
Language:English
Published: Nature Portfolio 2025-04-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-98162-1
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author Hidetaka Onda
Takuya Nishino
Mizuki Kojima
Nodoka Miyake
Kenta Shigeta
Naoki Tominaga
Shoji Yokobori
author_facet Hidetaka Onda
Takuya Nishino
Mizuki Kojima
Nodoka Miyake
Kenta Shigeta
Naoki Tominaga
Shoji Yokobori
author_sort Hidetaka Onda
collection DOAJ
description Abstract 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.
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spelling doaj-art-7441d3c86eae4ddaa3d2420844e4775a2025-08-20T03:14:07ZengNature PortfolioScientific Reports2045-23222025-04-011511810.1038/s41598-025-98162-1A scoring system with high predictive performance for poor outcomes in acute carbon monoxide poisoningHidetaka Onda0Takuya Nishino1Mizuki Kojima2Nodoka Miyake3Kenta Shigeta4Naoki Tominaga5Shoji Yokobori6Department of Disaster and Emergency Medicine, Kochi UniversityDepartment of Health Care Administration, Nippon Medical SchoolDepartment of Disaster and Emergency Medicine, Kochi UniversityDepartment of Emergency and Critical Care Medicine, Nippon Medical SchoolDepartment of Emergency and Critical Care Medicine, Nippon Medical SchoolDepartment of Emergency and Critical Care Medicine, Nippon Medical SchoolDepartment of Emergency and Critical Care Medicine, Nippon Medical SchoolAbstract 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.https://doi.org/10.1038/s41598-025-98162-1Intensive carePrognostic mode mortality and morbidity in toxicologyRisk stratificationPrognostic model
spellingShingle Hidetaka Onda
Takuya Nishino
Mizuki Kojima
Nodoka Miyake
Kenta Shigeta
Naoki Tominaga
Shoji Yokobori
A scoring system with high predictive performance for poor outcomes in acute carbon monoxide poisoning
Scientific Reports
Intensive care
Prognostic mode mortality and morbidity in toxicology
Risk stratification
Prognostic model
title A scoring system with high predictive performance for poor outcomes in acute carbon monoxide poisoning
title_full A scoring system with high predictive performance for poor outcomes in acute carbon monoxide poisoning
title_fullStr A scoring system with high predictive performance for poor outcomes in acute carbon monoxide poisoning
title_full_unstemmed A scoring system with high predictive performance for poor outcomes in acute carbon monoxide poisoning
title_short A scoring system with high predictive performance for poor outcomes in acute carbon monoxide poisoning
title_sort scoring system with high predictive performance for poor outcomes in acute carbon monoxide poisoning
topic Intensive care
Prognostic mode mortality and morbidity in toxicology
Risk stratification
Prognostic model
url https://doi.org/10.1038/s41598-025-98162-1
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