Predictive value of early cerebral oxygen utilization combined with the bispectral index for delayed encephalopathy after acute carbon monoxide poisoning in elderly patients / 中华老年医学杂志

ABSTRACT

Objective:To investigate clinical value of early cerebral oxygen utilization(O 2UCc)combined with the bispectral index(BIS)for monitoring delayed encephalopathy after acute carbon monoxide poisoning(DEACMP)in elderly patients. Methods:This was a retrospective analysis.A total of 90 elderly patients with acute severe carbon monoxide poisoning(ASCMP)treated in Harrison International Peace Hospital from Nov.2018 to Jan.2020 were considered as research objects.Patients were divided into the DEACMP group(n=25)and the good prognosis group(n=65)according to their prognosis.Oxygen quantity absorbed into UCC(O 2UCc)and Bispectral index(BIS)at different times in the early stages were compared between the two groups.Correlations of O 2UCc and BIS with the occurrence of DEACMP were analyzed.Clinical significance of O 2UCc or BIS alone and of the two parameters in combination for the prediction of DEACMP was investigated. Results:O 2UCc was higher and BIS was lower in the DEACMP group than in the good prognosis group at 0 h, 6 h, 12 h, and 24 h after admission(all P<0.01). Pearson correlation analysis showed that O 2UCc was negatively correlated with DEACMP( r0 h=-0.482, r6 h=-0.534, r12 h=-0.587, r24 h=-0.514, all P<0.01), BIS was positively correlated with DEACMP( r0 h=0.348, r6 h=0.583, r12 h=0.679, r24 h=0.489, all P<0.01), and the correlation was the strongest at 12h after admission.ROC curve analysis was performed with O2UCc, BIS and the combined predictors at 12 h, and the results showed that the areas under the ROC curve of O 2UCc, BIS and the two in combination for DEACMP prediction were 0.845, 0.850 and 0.909, respectively, the sensitivities were 78.5%, 90.8% and 96.9% and the specificities were 80.0%, 76.0% and 84.0%, respectively. Conclusions:Early detection of O 2UCc or BIS has a good clinical value for predicting the development of ASCMP to DEACMP, and their combined value is even better.