Namgung M, Oh J, Ahn C, Kim CW, Lee H, Kang H, et al.
Journal of personalized medicine. Date of publication 2022 Apr 14;volume 12(4):.
1. J Pers Med. 2022 Apr 14;12(4):635. doi: 10.3390/jpm12040635.
Association between Glasgow Coma Scale in Early Carbon Monoxide Poisoning and
Development of Delayed Neurological Sequelae: A Meta-Analysis.
Namgung M(1), Oh J(2), Ahn C(1), Kim CW(1), Lee H(2), Kang H(2).
Author information:
(1)Department of Emergency Medicine, College of Medicine, Chung-Ang University,
Seoul 06974, Korea.
(2)Department of Emergency Medicine, College of Medicine, Hanyang University,
Seoul 04763, Korea.
A significant number of people experience delayed neurologic sequelae after
acute carbon monoxide (CO) poisoning. The Glasgow Coma Scale (GCS) can be used
to predict delayed neurologic sequelae occurrence efficiently and without any
restrictions. Here, we investigated the association between a low GCS score
observed in cases of early CO poisoning and delayed neurologic sequelae
development through a meta-analysis. We systematically searched MEDLINE, EMBASE,
and the Cochrane Library for studies on GCS as a predictor of delayed neurologic
sequelae occurrence in patients with CO poisoning in June 2021. Two reviewers
independently extracted study characteristics and pooled data. We also conducted
subgroup analyses for the cutoff point for GCS. To assess the risk of bias of
each included study, we used the quality in prognosis studies tool. We included
2328 patients from 10 studies. With regard to patients with acute CO poisoning,
in the overall pooled odds ratio (OR) of delayed neurologic sequelae
development, those with a low GCS score showed a significantly higher value and
moderate heterogeneity (OR 2.98, 95% confidence interval (CI) 2.10−4.23, I2 =
33%). Additionally, in subgroup analyses according to the cutoff point of GCS,
the development of delayed neurologic sequelae was still significantly higher in
the GCS < 9 group (OR 2.80, 95% CI 1.91−4.12, I2 = 34%) than in the GCS < 10 or
GCS < 11 groups (OR 4.24, 95% CI 1.55−11.56, I2 = 48%). An initial low GCS score
in patients with early CO poisoning was associated with the occurrence of
delayed neurologic sequelae. Additionally, GCS was quickly, easily, and
accurately assessed. It is therefore possible to predict delayed neurologic
sequelae and establish an active treatment strategy, such as hyperbaric oxygen
therapy, to minimize neurological sequelae using GCS.
DOI: 10.3390/jpm12040635
PMCID: PMC9031955
PMID: 35455751
Conflict of interest statement: The authors declare no conflict of interest.
