Batna Journal of Medical Sciences
Volume 13, Numéro 6, Pages 499-506
2026-07-01

Identification Value Of A Multi-indicator Model For Lactic Acidosis In Acute Carbon Monoxide Poisoning: A Retrospective Cross-sectional Study



Authors : Ke Junjie . Zhu Decai .

Abstract

Objective: To analyze the association between admission clinical indicators and lactic acidosis in acute carbon monoxide (CO) poisoning patients, and to evaluate the identification value of a combined multi-indicator model. Methods: A single-center retrospective cross-sectional study enrolled 124 adult patients with acute CO poisoning admitted from December 2021 to December 2024. Patients were divided into lactic acidosis (blood lactate ≥4.0 mmol/L, n=43) and non-acidosis (lactate <4.0 mmol/L, n=81) groups. LASSO binary logistic regression with 10-fold cross-validation was used for variable selection, followed by multivariate logistic regression to identify independent associated factors. A combined model was developed and compared with a baseline model using ROC analysis, DeLong test, net reclassification improvement (NRI), integrated discrimination improvement (IDI), and decision curve analysis (DCA). Results: The incidence of lactic acidosis was 34.7%. LASSO regression screened 8 variables, and multivariate analysis identified respiratory rate (OR=1.25, 95% CI: 1.10–1.41, P<0.001), white blood cell count (OR=1.34, 95% CI: 1.18–1.53, P<0.001), and carboxyhemoglobin (OR=1.20, 95% CI: 1.11–1.29, P<0.001) as independently associated with lactic acidosis. The combined model achieved an AUC of 0.939 (95% CI: 0.894–0.984), significantly higher than the baseline model (AUC=0.802, P=0.0005). The categorical NRI was 0.5165 (P<0.001), continuous NRI was 1.1892 (P<0.001), and IDI was 0.3229 (P<0.001). DCA demonstrated consistent positive net benefit across threshold probabilities of 0.1–0.9. Conclusion: Respiratory rate, white blood cell count, and carboxyhemoglobin are independently associated with lactic acidosis in acute CO poisoning. The combined model exhibits excellent identification performance and clinical net benefit, supporting its application for emergency risk stratification.

Keywords

Acute carbon monoxide poisoning; Lactic acidosis; Independent associated factors; Multi-parameter screening; diagnostic value ; Acute carbon monoxide poisoning ; Lactic acidosis ; Independent associated factors ; Multi-parameter screeningdiagnostic value ; Multi-parameter screening; diagnostic value ; Multi-parameter screening ; diagnostic value

Les articles similaires

Predictors Of Mortality In Acute Paraquat Poisoning: South Indian Cohort Analysis

Subin B George .  Vijay Kumar S S .  Viswakanth Bhagavathula . 
pages 1-10.

A Retrospective Analysis Of Pediatric Poisoning Patterns And Clinical Outcomes In Algiers, Algeria

Boulahia Mohamed . 
pages 173-177.

Carbon Monoxide Measurement In Exhaled Air Among Gas Station Workers In Tlemcen, Algeria

Sedjelmaci Nesrine .  Chergui Zana .  Hamed Halima . 
pages 132-142.

The Reality Of Chronic Diseases In Older Persons In Algeria "comparative Study In The Light Of The Multiple Indicator Cluster Survey 2006 (mics 3) And The Multiple Indicator Cluster Survey 2012-2013 ( Mics 4)"

Gouarah Yamina .  Hammani Fadila . 
pages 70-81.

Prognostic Impact Of Genetic Abnormalities In Acute Myeloid Leukemia: A Retrospective Study At The University Hospital Of Oran

Cherif Hosni Aicha .  Kehal Samia .  Meghrebi Sara .  Lahmer Imene .  Messaoudi Reda . 
pages 452-459.

Formats de citation