• Shijun Yang, Huichun Liu, Qifeng Peng, Jinlan Li, and Qunhui Liu.
• Department of Neurology, The Central Hospital of Enshi Prefecture, 158 Wu Yang Ave., 445000, En Shi, Hubei Province, China.
• Am J Emerg Med. 2022 Feb 1; 52: 114118114-118.

ObjectiveTo establish and validate a predictive formula for calculating the possibility of developing delayed neurological sequelae (DNS) after acute carbon monoxide (CO) poisoning to facilitate better decision-making about treatment strategies.MethodsThis study retrospectively enrolled 605 consecutive patients who had been newly diagnosed with CO poisoning from the Central Hospital of Enshi Prefecture between January 1, 2015 and December 31, 2020. The cohort was randomly divided into two subgroups: the development cohort (n = 104) and validation cohort (n = 44). Univariate analysis and backward elimination of multivariate logistic regression were used to identify predictive factors, and a predictive formula was established. The performance was assessed using the area under the curve (AUC), the mean AUC of five-fold cross-validation, and calibration plots.ResultsThe formula included four commonly available predictors: initial GCS score, duration of exposure, CK, and abnormal findings on MRI. We next created a formula to calculate the risk score for developing DNS: Risk score = -4.54 + 3.35 * (Abnormal findings on MRI = yes) - 0.51 * (Initial GCS score) + 0.65 * (Duration of exposure) + 0.01 * (CK). Then, the probability of developing DNS could be calculated: Probability of DNS = 1/(1 + e Risk score). The model revealed good discrimination with AUC, and mean AUC of fivefold cross-validation in two cohort, and the calibration plots showed good calibration.ConclusionsThis study established a prediction predictive formula for predicting developing of DNS, which could facilitate better decision-making about treatment strategies.Copyright © 2021. Published by Elsevier Inc.

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