Association Between the COGAS Score and Delayed Neuropsychiatric Sequelae After Acute Carbon Monoxide Poisoning

Background/Objectives: Carbon monoxide (CO) poisoning remains a major cause of poisoning-related morbidity, and delayed neuropsychiatric sequelae (DNS) are important long-term complications. This study evaluated the association between the COGAS score and operationally defined 6-month DNS after acute CO poisoning. Methods: Overall, 272 patients with acute CO poisoning were included in this single-center observational cohort study. The primary outcome was operationally defined as 6-month DNS based on changes in the Global Deterioration Scale (GDS). Logistic regression analyses were performed to evaluate the association between the COGAS score and operationally defined 6-month DNS. Conventional and Firth penalized logistic regression models were used. Results: Among 272 patients, 14 (5.1%) met the criteria for operationally defined 6-month DNS. Each 1-point increase in the COGAS score was associated with higher odds of operationally defined 6-month DNS in univariable analysis (odds ratio [OR], 2.16; 95% confidence interval [CI], 1.30-3.65; p = 0.003) and in the fully adjusted model including initial GDS, troponin I, and CO exposure duration (OR, 2.19; 95% CI, 1.14-4.35; p = 0.020). Conclusions: Higher COGAS scores were associated with operationally defined 6-month DNS after acute CO poisoning. The COGAS score may provide prognostic information, but further validation in larger cohorts is needed.