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Myocardial injury predicts mortality in elderly carbon monoxide poisoning: development and internal validation of a
Yong Ai Ling1, Changsheng Ye2, Xianwei Xiong2
1Health Promotion Center, People's Hospital of Anji, Huzhou, Zhejiang Province, China.
Background:
Myocardial injury is a serious complication of acute carbon monoxide poisoning in elderly patients, we aimed to evaluate its association with short-term mortality and to develop a simplified prognostic model with internal validation.
Methods:
This retrospective cohort study with 90-day follow-up included consecutive patients aged ≥ 65 years with acute carbon monoxide poisoning (2019-2024). Myocardial injury was defined as cardiac troponin I ≥ 0.05 ng/mL. Analyses included non-parametric tests, survival analysis, and ROC curves.
Results:
Among 258 patients, 70 had myocardial injury. These patients were older and had higher rates of renal dysfunction, hospitalization, and severe neurological impairment, along with worse biochemical profiles (lower pH and base excess, reduced PaCO2, higher lactate). The 90-day mortality was significantly higher in the injury group (24.3% vs. 2.1%, P < 0.001). Myocardial injury was the strongest independent predictor of death (adjusted OR 8.16, 95% CI: 2.49-26.78), followed by neurological impairment and age. A model combining these three predictors showed good discriminative ability (AUC 0.879, 95% CI: 0.793-0.964).
Conclusion:
Myocardial injury is a key prognostic factor in elderly patients with carbon monoxide poisoning. A model incorporating myocardial injury, neurological status, and age may support risk stratification, pending external validation.
