Incidence patterns of nervous system diseases after carbon monoxide poisoning: a retrospective longitudinal study in South Korea from 2012 to 2018

Abstract

Objective To analyze the incidence patterns of nervous system diseases in survivors of carbon monoxide (CO) poisoning using nationwide claims data from South Korea. Methods A national cohort was abstracted from a database that includes patients diagnosed with CO poisoning between January 2012 and December 2018. For all nervous system diseases, we investigated the frequency, pattern of incidence, effect of intensive care unit admission, and the standardized incidence ratios (SIRs) to estimate the risk of nervous system disease after CO poisoning. ResultsOf 26,778 patients, 18,720 (69.9%) were diagnosed with nervous system diseases after CO poisoning. The most common disease was disorders of sleep initiation and maintenance (n = 701, 3.74%), followed by tension-type headache (n = 477, 2.55%) and anoxic brain injury (n = 406, 2.17%). Over half of the nervous system diseases occurred within the first year after CO poisoning. The cumulative hazard ratio for nervous system diseases in patients admitted to the intensive care unit was 2.25 (95% confidence interval [CI], 2.07-2.44). Among the frequent nervous system diseases after CO poisoning, patients had a higher risk of disorders of initiating and maintaining sleep (

Carbon Monoxide Poisoning was Associated With Lifetime Suicidal Ideation: Evidence From A Population-Based Cross-Sectional Study in Hebei Province, China

“…One of the explanations for this relationship was about the neuropsychiatric sequelae after CMP. As we introduced in the Introduction section, people who experienced CMP may have several neuropsychiatric sequelae, such as sleep problems, cognitive decline, chronic pain, and so on [ 8 , 31 ]. All of these sequelae of CMP were risk factors for suicidal ideation, which had been identified in previous studies [ 32 , 33 ].…”

“…Carbon monoxide poisoning (CMP), mainly caused by accidences [4,5], was a frequent cause of acute toxicity with high morbidity and mortality worldwide [6,7]. Previous studies had found that nervous system disorders, including sleep initiation and maintenance disorders, tension-type headache, occur in over half of the patients within the first years after CMP [8]. In recent years, several longitudinal studies also supported that sleep disorders can be warning signs for imminent suicidal thought and behaviors [9][10][11].…”

Prognostic value of the myeloperoxidase index for early prediction of neurologic outcome in acute carbon monoxide poisoning

“…Acute carbon monoxide (CO) poisoning can exhibit many symptoms and neurocognitive sequelae, including mental deterioration, cognitive dysfunction, amnesia, gait disturbance, mutism, urinary or fecal incontinence, psychosis, depression, and parkinsonism. [1][2][3] CO poisoning causes tissue hypoxia resulting from the high affinity of hemoglobin for CO and direct inflammatory damage to tissues through various mechanisms. CO competitively binds to heme-containing proteins (e.g., hemoglobin and myoglobin) and mitochondrial cytochrome c oxidase (complex IV), causing tissue hypoxia.…”

Serum phosphate is not an early predictor of neurocognitive outcomes in acute carbon monoxide poisoning patients

“…Patients with neurocognitive sequelae caused by CO poisoning may present with symptoms such as mental deterioration, cognitive dysfunction, amnesia, gait disturbance, mutism, urinary or fecal incontinence, psychosis, depression, and Parkinsonism [ 2 , 4 - 6 ]. Hyperbaric oxygen therapy (HBO 2 ) within 24 hours after poisoning is recommended for symptomatic patients with CO poisoning based on previous randomized control trials [ 7 , 8 ].…”