Background: Delayed neuropsychiatric sequela (DNS) has been described following carbon monoxide (CO) poisoning. There is a need to identify a new prognostic marker for predicting DNS after acute CO intoxication. This study aimed to investigate the predictive value of initial levels of serum neurogranin (Ng) and creatine kinase-brain (CK-BB) and their role as predictors of DNS in patients with acute CO poisoning.
Methods: This prospective cohort study was conducted on 40 patients of both genders with acute CO poisoning. All participants underwent a comprehensive history taking, clinical examination, and laboratory investigations, including the estimation of serum Ng and CK-BB levels. These cases were followed up for 3 months after acute exposure to CO for DNS signs.
Results: Creatine kinase, CK-BB levels, and plasma Ng levels were significantly higher in DNS-complicated patients, compared to non-complicated ones. Patients with complicated DNS had significantly lower neurological examination, Mini-Mental State Examination (MMSE), and Montreal Cognitive Assessment (MoCA) scores than those with uncomplicated DNS. Based on receiver operating characteristic analysis, COHb, CK-BB, Ng levels, and GCS had cut-off values of >20%, 18.9 U/ L, 10.42 ng/mL, and ≤14, respectively. The sensitivities were 95.65%, 91.3%, 95.65%, and 78.26%, respectively.
Conclusion: Initial serum Ng and CK levels may be helpful predictors of DNS after acute CO poisoning.