Prognostic factors of hyperbaric oxygen therapy for patients with delayed encephalopathy after acute carbon monoxide poisoning

Fangling Huang; Lin Yang; Zhen Tan; Bangmin Yang; Pingqiong Liu; Zuomin Li; Wanli Shi; Kun Peng; Jing Yuan; Qing He; Li Yang; Xinyu Li; Can Li; Dezhong Chen; Zhengrong Peng

doi:10.1016/j.heliyon.2022.e12351

Prognostic factors of hyperbaric oxygen therapy for patients with delayed encephalopathy after acute carbon monoxide poisoning

Heliyon. 2022 Dec 15;8(12):e12351. doi: 10.1016/j.heliyon.2022.e12351. eCollection 2022 Dec.

Authors

Fangling Huang^{1

2}, Lin Yang³, Zhen Tan⁴, Bangmin Yang⁵, Pingqiong Liu⁶, Zuomin Li⁷, Wanli Shi⁸, Kun Peng⁹, Jing Yuan¹⁰, Qing He¹¹, Li Yang¹², Xinyu Li¹³, Can Li¹⁴, Dezhong Chen¹⁵, Zhengrong Peng^{1

2}

Affiliations

¹ Department of Hyperbaric Oxygen, Xiangya Hospital, Central South University, Changsha, Hunan Province 410008, China.
² National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan Province 410008, China.
³ Department of Hyperbaric Oxygen, Changsha Central Hospital, Changsha, Hunan Province 410028, China.
⁴ Department of Hyperbaric Oxygen, The First People's Hospital of Changde City, Changde, Hunan Province 415003, China.
⁵ Department of Hyperbaric Oxygen, The First People' Hospital of Huaihua, Huaihua, Hunan Province 418099, China.
⁶ Department of Hyperbaric Oxygen, Yiyang Central Hospital, Yiyang, Hunan Province 413099, China.
⁷ Department of Hyperbaric Oxygen, Chenzhou No 1 People's Hospital, Chenzhou, Hunan Province 423099, China.
⁸ Department of Hyperbaric Oxygen, People' Hospital of Xiangxi Tujia and Miao Autonomous Prefecture, Jishou, Hunan Province 416007, China.
⁹ Department of Hyperbaric Oxygen, Yueyang Central Hospital, Yueyang, Hunan Province 414020, China.
¹⁰ Department of Hyperbaric Oxygen, Zhangjiajie People's Hospital, Zhangjiajie, Hunan Province 427099, China.
¹¹ Department of Neurosurgery, Yongzhou Central Hospital, Yongzhou, Hunan Province 425002, China.
¹² Department of Hyperbaric Oxygen, Central Hospital of Shaoyang, Shaoyang, Hunan Province 422099, China.
¹³ Department of Hyperbaric Oxygen, Hengyang Central Hospital, Hengyang, Hunan Province 421001, China.
¹⁴ Department of Hyperbaric Oxygen, Xiangya Boai Rehabilitation Hospital, Changsha, Hunan Province 410199, China.
¹⁵ Department of Hyperbaric Oxygen, Zhuzhou Central Hospital, Zhuzhou, Hunan Province 412001, China.

Abstract

Delayed encephalopathy after acute carbon monoxide poisoning (DEACMP) is a disease with an incomplete pathological mechanism, long treatment time, and uncertain factors affecting the therapeutic effect. This study explored prognostic factors for DEACMP patients treated with hyperbaric oxygen therapy (HBOT) in 15 hospitals in China. The findings might provide a theoretical basis for further improving the prognosis of DEACMP patients. In this study, data from 330 patients with DEACMP who were admitted to HBOT centers of 15 hospitals in Hunan Province (China) from June 2015 to June 2020 were retrospectively analyzed, and their medical records related to disease prognosis were collected and followed up by telephone. Univariate and multivariate analyses were used to identify independent risk factors for the prognosis of DEACMP patients after HBOT. Univariate analysis revealed 11 possible prognostic factors. Consistent with univariate analysis, multivariate analysis found that underlying diseases (Odds radio(OR) = 2.886, P = 0.048), hypermyotonia (OR = 5.2558, P = 0.008), and HBOT pressure no less Than 2.3 atm absolute (ATA) ((OR = 7.812, P = 0.004) were identified as independent prognostic factors among 20 variables for poor prognosis of DEACMP patients treated with HBOT in the study. This multicenter retrospective analysis revealed that the adverse prognostic markers for DEACMP patients treated with HBOT might be underlying diseases, hypermyotonia, and an HBOT pressure of 2.3 ATA or higher.

Keywords: Delayed encephalopathy after acute carbon monoxide poisoning; Hyperbaric oxygen therapy; Prognostic factors.