initial levels of serum neurogranin and creatine kinase as predictors of delayed neuropsychiatric sequelae of acute carbon monoxide poisoning

Background: delayed neuropsychiatric sequela (dns) has been described following carbon monoxide (co) poisoning. there is a need to identify a new prognostic marker for predicting dns after acute co intoxication. this study aimed to investigate the predictive value of initial levels of serum neurogranin (ng) and creatine kinase-brain (ck-bb) and their role as predictors of dns in patients with acute co poisoning. methods: this prospective cohort study was conducted on 40 patients of both genders with acute co poisoning. all participants underwent a comprehensive history taking, clinical examination, and laboratory investigations, including the estimation of serum ng and ck-bb levels. these cases were followed up for 3 months after acute exposure to co for dns signs.results: creatine kinase, ck-bb levels, and plasma ng levels were significantly higher in dns-complicated patients, compared to non-complicated ones. patients with complicated dns had significantly lower neurological examination, mini-mental state examination (mmse), and montreal cognitive assessment (moca) scores than those with uncomplicated dns. based on receiver operating characteristic analysis, cohb, ck-bb, ng levels, and gcs had cut-off values of >20%, 18.9 u/ l, 10.42 ng/ml, and ≤14, respectively. the sensitivities were 95.65%, 91.3%, 95.65%, and 78.26%, respectively. conclusion: initial serum ng and ck levels may be helpful predictors of dns after acute co poisoning.