title: A positive Babinski reflex predicts delayed neuropsychiatric sequelae in Chinese patients with carbon monoxide poisoning.
abstract: As the human population increased in China, the carbon monoxide is a serious environmental toxin in public health. However, predicting the delayed neuropsychiatric sequelae (DNS) of carbon monoxide poisoning (COP) has not been well studied. We investigated the independent predictors of DNS in patients with COP. This study was conducted at four hospitals in China. Data were retrospectively collected from 258 patients with COP between November 1990 and October 2011. DNS was the primary endpoint. A positive Babinski reflex was the independent predictor for DNS: sensitivity = 53.8% (95% confidence interval [CI]: 26.1-79.6), specificity = 88.6% (95% CI: 83.7-92.1), positive predictive value (PPV) = 20.0% (95% CI: 9.1-37.5), and negative predictive value (NPV) = 97.3% (95% CI: 94.0-98.9). The area under the receiver operating characteristic curve = 0.712 (95% CI: 0.544-0.880). A positive Babinski reflex was very memorable, immediately available, and applicable in clinical practice. Even when the sensitivity and PPV of a positive Babinski reflex were unsatisfactory, it had a good specificity and NPV for excluding the risk of DNS. In patients without a positive Babinski reflex, the risk for DNS was only 2.7%. This finding may help physicians make decisions about dispositions for patients with COP.
authors: Clinical Division of Occupational Medicine, Institute of Occupational Health and Occupational Medicine, Academy of Medical Science, Shandong Province 250000, China.
authors: Jian-Fang
authors: JF
authors: Zou
authors: Clinical Division of Occupational Medicine, Institute of Occupational Health and Occupational Medicine, Academy of Medical Science, Shandong Province 250000, China.
authors: Qiming
authors: Q
authors: Guo
authors: Clinical Division of Occupational Medicine, Institute of Occupational Health and Occupational Medicine, Academy of Medical Science, Shandong Province 250000, China.
authors: Hua
authors: H
authors: Shao
authors: Division of Toxicology, National Institute of Occupational Health and Poison Control, Beijing 100050, China.
authors: Bin
authors: B
authors: Li
authors: Department of Medicine, Second People's Hospital of Dongying, Shandong Province 250000, China.
authors: Yuxiu
authors: Y
authors: Du
authors: Department of Medicine, Qilu Petrochemical Corporation Hospital, Shandong Province 250000, China.
authors: Maofeng
authors: M
authors: Liu
authors: Department of Medicine, Qilu Petrochemical Corporation Hospital, Shandong Province 250000, China.
authors: Fengling
authors: F
authors: Liu
authors: Department of Medicine, Second People's Hospital of Kenli, Shandong Province 250000, China.
authors: Lixin
authors: L
authors: Dai
authors: Department of Emergency Medicine, Chi-Mei Medical Center, Tainan 710, Taiwan ; Department of Emergency Medicine, Chi-Mei Medical Center, Liouying, Tainan 710, Taiwan.
authors: Min-Hsien
authors: MH
authors: Chung
authors: Department of Emergency Medicine, Chi-Mei Medical Center, Tainan 710, Taiwan ; Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan 710, Taiwan ; Department of Emergency Medicine, Taipei Medical University, Taipei 110, Taiwan.
authors: Hung-Jung
authors: HJ
authors: Lin
authors: Department of Environmental and Occupational Health, Medical College, National Cheng Kung University, Tainan 701, Taiwan ; Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan 701, Taiwan.
authors: How-Ran
authors: HR
authors: Guo
authors: Department of Emergency Medicine, Chi-Mei Medical Center, Tainan 710, Taiwan.
authors: Tzu-Meng
authors: TM
authors: Yang
authors: Department of Emergency Medicine, Chi-Mei Medical Center, Tainan 710, Taiwan ; Department of Child Care and Education, Southern Taiwan University of Science and Technology, Tainan 710, Taiwan.
authors: Chien-Cheng
authors: CC
authors: Huang
authors: Department of Emergency Medicine, Chi-Mei Medical Center, Tainan 710, Taiwan ; Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan 710, Taiwan.
authors: Chien-Chin
authors: CC
authors: Hsu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D002248:Carbon Monoxide / Q000633:toxicity*; D002249:Carbon Monoxide Poisoning / Q000473:pathology*; D002681:China; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D001405:Reflex, Babinski; D012189:Retrospective Studies
chemical_list: D002248:Carbon Monoxide