The inflammatory markers MHR and NLR are independent risk factors for adverse events during hospitalization in older adult patients with myocardial injury caused by acute carbon monoxide poisoning: a retrospective cross-sectional study

Acute carbon monoxide poisoning-induced myocardial injury is easily overlooked. However, patients with acute carbon monoxide poisoning, especially older adult patients, often have difficulty expressing clinical symptoms due to early consciousness disturbances, making the early identification of complications challenging and leading to delayed diagnosis and treatment. Therefore, exploring indicators that can predict in-hospital cardiovascular adverse events in older adult patients with acute carbon monoxide poisoning -induced myocardial injury has important clinical significance. Therefore, this retrospective cross-sectional study included older adult patients with acute carbon monoxide poisoning-induced myocardial injury at the Department of Hyperbaric Oxygen of Beijing Chao-Yang Hospital from January 2013 to December 2019. A total of 119 older adult patients with acute carbon monoxide poisoning-induced myocardial injury were included in the study, with 94 patients in the nonevent group (54 males, 40 females, 71.09 ± 7.60 years) and 25 patients in the cardiovascular adverse event group (10 males, 15 females, 71.48 ± 10.38 years). Compared with those in the nonevent group, creatine kinase isoenzyme levels, triglyceride levels, the neutrophil/lymphocyte ratio and the monocyte/high-density lipoprotein cholesterol ratio were significantly greater in the cardiovascular adverse event group, and high-density lipoprotein cholesterol levels were significantly lower in the cardiovascular adverse event group. Further binary logistic regression analysis showed that higher monocyte/high-density lipoprotein cholesterol ratio might be an independent risk factor for in-hospital adverse events in older adult patients with acute carbon monoxide poisoning-induced myocardial injury (OR = 109.783, 95% CI: 2.644-4557.834; P = 0.013). The area under the curve of the monocyte/high-density lipoprotein cholesterol ratio in predicting in-hospital cardiovascular adverse events in older adult patients with myocardial injury due to acute carbon monoxide poisoning was 0.797, the cutoff value was 0.645, the sensitivity was 68.0%, and the specificity was 88.2%. The inflammatory indicators monocyte/high-density lipoprotein cholesterol ratio and neutrophil/lymphocyte ratio were identified as an independent risk factor for predicting in-hospital cardiovascular adverse events in older adult patients with acute carbon monoxide poisoning-induced myocardial injury in this study. Specifically, monocyte/high-density lipoprotein cholesterol ratio was identified as an independent risk factor for predicting adverse events during hospitalization.