Myocardial Injury Predicts Mortality in Elderly Carbon Monoxide Poisoning: Development and Internal Validation of a Simple Prognostic Model

BACKGROUND: Myocardial injury is a serious complication of acute carbon monoxide poisoning in elderly patients, we aimed to evaluate its association with short-term mortality and to develop a simplified prognostic model with internal validation. METHODS: This retrospective cohort study with 90-day follow-up included consecutive patients aged ≥ 65 years with acute carbon monoxide poisoning (2019-2024). Myocardial injury was defined as cardiac troponin I ≥ 0.05 ng/mL. Analyses included non-parametric tests, survival analysis, and ROC curves. Myocardial injury was the strongest independent predictor of death (adjusted OR 8.16, 95% CI: 2.49-26.78), followed by neurological impairment and age. A model combining these three predictors showed good discriminative ability (AUC 0.879, 95% CI: 0.793-0.964). CONCLUSION: Myocardial injury is a key prognostic factor in elderly patients with carbon monoxide poisoning. A model incorporating myocardial injury, neurological status, and age may support risk stratification, pending external validation.