Gao et al reported a number of prognostic factors for a patient with prolonged coma following carbon monoxide poisoning. These can help to identify a patient who has a worse prognosis. The authors are from Beijing Chao-Yang Hospital and Capital Medical University in Beijing.
Patient selection: prolonged coma (> 7 days) after carbon monoxide poisoning
Predictors of worse outcome:
(1) older age (>= 50 years; prognosis is better in young patients)
(2) respiratory failure
(3) hypotension
(4) renal failure
(5) changes in brain CT scan
(5a) >= 3 CNS lesions on imaging studies
(5b) simultaneous damage to white matter AND globus pallidus or basal ganglia
(5c) Fazekas Grade 3 (severe) in white matter (periventricular or deep white matter)
(5d) extensive white matter damage
A patient without any of these predictors can recover, but in general prolonged coma is a poor prognostic finding.
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