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Increased Long-Term Risk of Dementia in Patients With Carbon Monoxide Poisoning

View Article: PubMed Central - PubMed

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.

No MeSH data available.


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Subgroup analysis of risk of dementia among patients with carbon monoxide intoxication and matched cohort.
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Figure 2: Subgroup analysis of risk of dementia among patients with carbon monoxide intoxication and matched cohort.

Mentions: After age stratification (Figure 2), the adjusted HR for dementia was 10.72 (95% CI, 4.76–24.13) for patients aged 18 to 44 years in the study cohort, which was higher than that reported for patients in the comparison cohort. Similarly, the adjusted HRs for dementia were 6.87 (95% CI, 4.23–11.15) and 2.63 (95% CI, 2.07–3.34) in patients aged 45 to 64 years and > 65 years, respectively, in the study cohort, which were higher than those for patients in the same age groups in the comparison cohort. We analyzed the data stratified by sex, comorbidity status, and CCI (≤1 or >1). The adjusted HR for dementia in the CO poisoning cohort stratified by sex, comorbidity status, and CCI (≤1 or >1) during the 9-year follow-up period were all higher than that in the comparison cohort, respectively. We further analyzed the data stratified by the existence of stroke or not. However, because of a small sample size and lack of power, the adjusted HR was not significantly higher (HR: 1.34, 95% CI, 0.91–1.99) for patients with stroke in the study cohort than for patients in the comparison group. The distribution of patients diagnosed with CO poisoning by the time of the emergency department visit is shown in the Figure 3. The frequency of CO poisoning were increased in winter months every year.


Increased Long-Term Risk of Dementia in Patients With Carbon Monoxide Poisoning
Subgroup analysis of risk of dementia among patients with carbon monoxide intoxication and matched cohort.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4998278&req=5

Figure 2: Subgroup analysis of risk of dementia among patients with carbon monoxide intoxication and matched cohort.
Mentions: After age stratification (Figure 2), the adjusted HR for dementia was 10.72 (95% CI, 4.76–24.13) for patients aged 18 to 44 years in the study cohort, which was higher than that reported for patients in the comparison cohort. Similarly, the adjusted HRs for dementia were 6.87 (95% CI, 4.23–11.15) and 2.63 (95% CI, 2.07–3.34) in patients aged 45 to 64 years and > 65 years, respectively, in the study cohort, which were higher than those for patients in the same age groups in the comparison cohort. We analyzed the data stratified by sex, comorbidity status, and CCI (≤1 or >1). The adjusted HR for dementia in the CO poisoning cohort stratified by sex, comorbidity status, and CCI (≤1 or >1) during the 9-year follow-up period were all higher than that in the comparison cohort, respectively. We further analyzed the data stratified by the existence of stroke or not. However, because of a small sample size and lack of power, the adjusted HR was not significantly higher (HR: 1.34, 95% CI, 0.91–1.99) for patients with stroke in the study cohort than for patients in the comparison group. The distribution of patients diagnosed with CO poisoning by the time of the emergency department visit is shown in the Figure 3. The frequency of CO poisoning were increased in winter months every year.

View Article: PubMed Central - PubMed

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.

No MeSH data available.


Related in: MedlinePlus