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Patients With Carbon Monoxide Poisoning and Subsequent Dementia: A Population-Based Cohort Study
Ching-Yuan Lai1, Yu-Wei Huang, Chun-Hung Tseng
1From the Department of Emergency Medicine, China Medical University Hospital, Taichung (C-YL); Department of Critical Care Medicine, E-DA Hospital, Department of Community Medicine, E-DA Hospital and I-Shou University Kaohsiung (Y-WH), Department of Neurology, China Medical University Hospital (C-HT), Management Office for Health Data China Medical University Hospital (C-LL), College of Medicine (C-LL), Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine (C-HK), Department of Health Services Administration (F-CS); and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan (C-HK).
Abstract:
The present study evaluated the dementia risk after carbon monoxide poisoning (CO poisoning). Using the National Health Insurance Research Database of Taiwan, a total of 9041 adults newly diagnosed with CO poisoning from 2000 to 2011 were identified as the CO poisoning cohort. Four-fold (N = 36,160) of non-CO poisoning insured people were randomly selected as controls, frequency-matched by age, sex, and hospitalization year. Incidence and hazard ratio (HR) of dementia were measured by the end 2011. The dementia incidence was 1.6-fold higher in the CO exposed cohort than in the non-exposed cohort (15.2 vs 9.76 per 10,000 person-years; n = 62 vs 174) with an adjusted HR of 1.50 (95% CI = 1.11-2.04). The sex- and age-specific hazards were higher in male patients (adjusted HR = 1.74, 95% CI = 1.20-2.54), and those aged <= 49 years (adjusted HR = 2.62, 95% CI = 1.38-4.99). CO exposed patients with 7-day or longer hospital stay had an adjusted HR of 2.18 (95% CI = 1.42, 3.36). The CO poisoning patients on hyperbaric oxygen (HBO2) therapy had an adjusted HR of 1.80 (95% CI = 0.96-3.37). This study suggests that CO poisoning may have association with the risk of developing dementia, which is significant for severe cases. The effectiveness of HBO2 therapy remains unclear in preventing dementia. Patients with CO poisoning are more prevalent with depression.
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