{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T06:46:35Z","timestamp":1782283595964,"version":"3.54.5"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Severe delayed encephalopathy after acute carbon monoxide poisoning (s-DEACMP) is a disabling complication associated with substantial long-term neurological impairment, yet reliable predictors for risk stratification during acute hospitalization remain limited. This study aimed to identify predictors associated with s-DEACMP and to develop a preliminary predictive model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this retrospective single-center cohort study, 200 patients with acute carbon monoxide poisoning (ACMP) admitted between 2017 and 2024 were analyzed. Patients were categorized into DEACMP (\n                      <jats:italic>n<\/jats:italic>\n                      = 140) and non-DEACMP (\n                      <jats:italic>n<\/jats:italic>\n                      = 60) groups; the DEACMP group was further stratified into severe (s-DEACMP,\n                      <jats:italic>n<\/jats:italic>\n                      = 97) and mild-to-moderate (m-DEACMP,\n                      <jats:italic>n<\/jats:italic>\n                      = 43) subgroups based on Activities of Daily Living scores assessed at peak disease severity during hospitalization. Clinical characteristics were compared between the s-DEACMP group and a combined control group (n-DEACMP + m-DEACMP). Independent predictors were identified using multivariate logistic regression. A nomogram was constructed and internally validated using receiver operating characteristic (ROC) curves, calibration analysis, and decision curve analysis (DCA).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients with s-DEACMP were significantly older and had longer duration of disturbance of consciousness, higher prevalence of hypertension and hyperhomocysteinemia, elevated D-dimer levels, and lower serum albumin concentrations compared with controls (all\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.05). Multivariate analysis identified age &amp;gt;40 years (OR = 31.90, 95% CI = 3.93\u2013259.14), disturbance of consciousness &amp;gt;24 h (OR = 3.06, 95% CI = 1.58\u20135.94), hypertension (OR = 1.99, 95% CI = 1.02\u20133.90), and hyperhomocysteinemia (OR = 2.57, 95% CI = 1.24\u20135.31) as factors independently associated with s-DEACMP. The nomogram demonstrated acceptable discrimination and calibration.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The proposed nomogram may assist in identifying patients at increased risk for s-DEACMP during acute hospitalization. External multicenter validation is required before broader clinical application.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1857056","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T05:48:07Z","timestamp":1782280087000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A clinical nomogram incorporating hyperhomocysteinemia for predicting severe delayed encephalopathy after acute carbon monoxide poisoning: a retrospective single-center study"],"prefix":"10.3389","volume":"13","author":[{"given":"Wanqiu","family":"Zhu","sequence":"first","affiliation":[{"name":"Department of Hyperbaric Oxygen, Beijing Chao-Yang Hospital (Changying Campus), Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Hyperbaric Oxygen, 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