COGAS Score of Kim et al for Predicting Poor Neurocognitive Outcomes in Acute Carbon Monoxide Poisoning

Description

Kim et al reported a score for predicting poor neurocognitive outcome for a patient with acute carbon monoxide poisoning. This can help to identify a patient who may benefit from more aggressive management. The authors are from Yonsei University and Inha University in South Korea.

COGAS is an acronym for creatinine kinase, oxygen, GCS, age and shock.

Patient selection: acute carbon monoxide poisoning

Outcome: neurocognitive status 1 month after exposure using the Global Deterioration Scale (GDS). A poor outcome was a GDS scale of 4 to 7.

Parameters:

(1) age in years

(2) Glasgow coma scale (GCS)

(3) shock

(4) hyperbaric oxygen therapy

(5) serum creatinine kinase in U/L

Parameter	Finding	Points
age in years	<= 50 years	0
	> 50 years	1
GCS	13 to 15	0
	3 to 12	1
shock	no	0
	yes	1
hyperbaric oxygen therapy	no	1
	yes	0
serum creatinine	<= 320 U/L	0
	> 320 U/L	1

total score =

= SUM(points for all of the parameters)

Interpretation:

• minimum score: 0

• maximum score: 5

• The probability of a poor outcome 1 month after the exposure significantly increased with increasing scores.

Score	Poor Outcomes
0	1.3 to 2.3%
1	2.5 to 2.7%
2	9.3 to 16.3%
3	43 to 57%
4	77 to 88%
5	83 to 100%

Performane:

• The area under the ROC curve is 0.86.

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