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Increased Long-Term Risk of Dementia in Patients With Carbon Monoxide Poisoning: A Population-Based Study
Chung-Shun Wong1, Ying-Chin Lin, Li-Yee Hong
1From the Emergency Department, Shuang Ho Hospital (CSW, H-PM, S-HT); Graduate Institute of Clinical Medicine, College of Medicine (CSW, Y-FL); Emergency department, school of Medicine, Taipei Medical University, Taipei (CSW, H-PM); Department of Family Medicine, Shuang Ho Hospital (Y-CL); Department of Family Medicine, School of Medicine, College of Medicine (Y-CL); Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University (LYH, Y-HH, Y-FL, M-YW); Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University (T-TC, M-YW); Department of Internal Medicine, School of Medicine, College of Medicine (Y-HH, Y-FL, M-YW); and College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan (S-HT).
Abstract:
Carbon monoxide (CO) poisoning may cause toxicity of the central nervous system and heart. However, the association between CO poisoning and long-term dementia risk remains unestablished. We investigated the incidence of dementia in patients with CO poisoning in Taiwan and evaluated whether they had a higher risk of dementia than did the general population.A nationwide population-based cohort study was conducted among patients with CO poisoning identified using Taiwan's National Health Insurance Research Database (NHIRD) during 2004 to 2013. CO poisoning was defined according to the International Classification of Diseases, Ninth Revision, Clinical Modification codes. The study cohort comprised patients with CO poisoning between 2005 and 2010 (N = 14,590). Each patient was age-, sex-, and index date-matched with 4 randomly selected controls from the comparison cohort (N = 58,360). All patients were followed from the study date until dementia development, death, or the end of 2013. Cox proportional hazards regressions were performed for comparing the hazard ratios for dementia between the 2 cohorts.Incident cases of dementia were identified from the NHIRD.After adjustment for potential confounders, the study cohort was independently associated with a higher dementia risk (adjusted hazard ratio, 2.75; 95% confidence interval, 2.26-3.35).This population-based cohort study indicated that patients with CO poisoning have a higher risk of dementia than do people without CO poisoning.
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