The neutrophil-to-lymphocyte ratio is associated with the frequency of delayed neurologic sequelae in patients with carbon monoxide poisoning

Delayed neurologic sequelae (DNS) is a common complication in patients with carbon monoxide poisoning (COP). We aimed to investigate the association of the neutrophil-to-lymphocyte ratio (NLR) with the frequency of DNS in COP patients. A total of 371 COP patients were investigated in retrospective and prospective studies. A receiver operator curve (ROC) test was performed to evaluate the ability of the NLR to predict DNS in COP patients. The retrospective study included 288 COP patients, of whom 84 (29.2%) were confirmed to have DNS, and 1 (0.3%) died within 28 days. The NLR in the DNS group was significantly higher than that in the non-DNS group (6.84 [4.22–12.43] vs. 3.23 [1.91–5.60] × 10(9)/L). NLR was a significant predictor of the frequency of DNS [odds ratio (OR): 1.130, 95% confidence interval (CI): 1.030, 1.240] in COP patients. The area under the ROC curve of NLR for predicting DNS was 0.766 (95% CI 0.701, 0.832), and the cut-off value was 3.745 (sensitivity, 83.3%; specificity, 58.8%). The prospective study included 83 COP patients, of whom 19 (22.9%) were confirmed to have DNS, and all patients survived. Moreover, the frequency of DNS in the patients with an NLR ≥ 3.745 was notably higher than that in the patients with an NLR < 3.745 [41.4% (12/29) vs. 13.0 (7/54)]. In conclusion, the NLR was a significant, independent predictor of the frequency of DNS in COP patients.