Study of the value of homocysteine levels in predicting cognitive dysfunction in patients after acute carbon monoxide poisoning

PURPOSE: The purpose of this research was to assess the value of homocysteine (HCY) levels in predicting cognitive dysfunction in patients after acute carbon monoxide (CO) poisoning. METHODS: A total of 115 patients who were admitted to the emergency department of Yinzhou NO. 2 Hospital after CO poisoning between January 2017 and December 2021 were enrolled in this retrospective study. All patients were followed up for 1 month. According to the Mini–Mental State Examination (MMSE) scores, patients were divided into two groups. The demographic and clinical characteristics and magnetic resonance imaging (MRI) results were gathered and statistically analysed. RESULTS: Twenty-six and 89 patients were ultimately enrolled in the cognitive dysfunction and control groups, respectively. There were significant differences between the groups in terms of age, coma duration, and carboxyhaemoglobin (COHB), lactate and HCY levels (p < 0.05), but there were no significant differences in white blood cell (WBC) counts or aspartate transaminase (AST), alanine transaminase (ALT), creatinine, troponin T, creatinine kinase (CK), or creatinine kinase muscle and brain (CK-MB) levels (p > 0.05). Univariate and multivariate analyses identified that a higher HCY level (OR 2.979, 95% CI 1.851-5.596, p < 0.001) was an independent risk factor for patient cognitive dysfunction after acute CO poisoning. Linear regression analysis showed a negative correlation between MMSE scores and HCY levels (r = − 0.880, P < 0.001). According to the MRI results, the most common lesion site was the globus pallidus, and the central ovale, diffuse white matter, corona radiata, basal ganglia (other than the globus pallidus) and cerebral cortex were also involved. CONCLUSIONS: Higher HCY levels were associated with cognitive impairment and were independent risk factors for cognitive impairment after acute CO poisoning. The level of HCY was negatively correlated with the degree of cognitive impairment.