Carbon monoxide poisoning is associated with an increased risk of epilepsy and status epilepticus: a nationwide population-based cohort study conducted in the Republic of Korea between 2002-2021.

IF 3 3区 医学 Q2 TOXICOLOGY
Heewon Hwang, Solam Lee, Kyung Min Kim, Yong Sung Cha
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引用次数: 0

Abstract

Introduction: Carbon monoxide poisoning may result in various neurological injuries, including acute symptomatic seizures. We aimed to investigate the long-term risk of epilepsy and status epilepticus in patients with previous carbon monoxide poisoning.

Methods: The study population was derived from the National Health Insurance Service database of the Republic of Korea between 1 January 2002 and 31 December 2021. We included adults with at least one documented visit to medical facilities because of carbon monoxide poisoning (International Classification of Diseases, Tenth Revision, code T58). Patients were matched, on the same index date, with controls, without a T58 code, for age, sex, insurance type, income level, and residence location in a 1:1 ratio. Follow-up continued until death, migration, or the end of the observation period (31 December 2021). The primary outcome was the incidence of epilepsy (codes G40 or R56) and status epilepticus (code G41).

Results: This study included 53,380 patients with carbon monoxide poisoning and 53,380 controls, with 44.2% women and a mean age of 45.7 years. The mean (±SD) follow-up period was 5.7 ± 4.3 years in the carbon monoxide poisoned group and 6.4 ± 4.4 years in controls. The overall risk of epilepsy (adjusted hazard ratio 2.60; 95% CI: 2.43-2.78; P < 0.001) and status epilepticus (adjusted hazard ratio 4.10; 95% CI: 2.84-5.92; P < 0.001) was significantly increased in the carbon monoxide poisoned group compared to controls. The risk of epilepsy and status epilepticus was increased in patients with previous carbon monoxide poisoning, regardless of sex, age or a history of stroke, neurodegenerative diseases, or central nervous system tumour or infection. However, in the subgroup analysis according to age, the highest risk of epilepsy and status epilepticus was observed in patients less than 40 years of age.

Discussion: In this population-based cohort study, previous carbon monoxide poisoning was associated with an increased risk of epilepsy and status epilepticus. The risk was more noticeable in patients aged less than 40 years. Further studies are needed to confirm such an association in other populations.

Conclusions: Previous carbon monoxide poisoning was associated with an increased risk of epilepsy and status epilepticus, particularly in the younger population. The long-term management of survivors of carbon monoxide poisoning should include monitoring for epilepsy and status epilepticus.

一氧化碳中毒与癫痫和癫痫状态风险增加有关:2002-2021 年期间在大韩民国开展的一项全国性人群队列研究。
一氧化碳中毒一氧化碳中毒可能导致各种神经损伤,包括急性症状性癫痫发作。我们旨在调查曾发生过一氧化碳中毒的患者发生癫痫和癫痫状态的长期风险:研究人群来自 2002 年 1 月 1 日至 2021 年 12 月 31 日期间的大韩民国国民健康保险服务数据库。我们将至少有一次因一氧化碳中毒(《国际疾病分类》第十版,代码 T58)而到医疗机构就诊的记录在案的成年人纳入研究对象。在同一发病日期,患者与未使用 T58 代码的对照组在年龄、性别、保险类型、收入水平和居住地等方面按 1:1 的比例进行匹配。随访一直持续到患者死亡、迁移或观察期结束(2021 年 12 月 31 日)。主要结果是癫痫(代码 G40 或 R56)和癫痫状态(代码 G41)的发生率:这项研究包括 53380 名一氧化碳中毒患者和 53380 名对照组患者,其中女性占 44.2%,平均年龄为 45.7 岁。一氧化碳中毒组的平均(±SD)随访时间为 5.7 ± 4.3 年,对照组为 6.4 ± 4.4 年。癫痫的总体风险(调整后危险比为 2.60;95% CI:2.43-2.78;P P 讨论:在这项基于人群的队列研究中,既往一氧化碳中毒与癫痫和癫痫状态风险增加有关。这种风险在 40 岁以下的患者中更为明显。要在其他人群中证实这种关联,还需要进一步的研究:结论:既往一氧化碳中毒与癫痫和癫痫状态风险增加有关,尤其是在年轻人群中。对一氧化碳中毒幸存者的长期管理应包括监测癫痫和癫痫状态。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Clinical Toxicology
Clinical Toxicology 医学-毒理学
CiteScore
5.70
自引率
12.10%
发文量
148
审稿时长
4-8 weeks
期刊介绍: clinical Toxicology publishes peer-reviewed scientific research and clinical advances in clinical toxicology. The journal reflects the professional concerns and best scientific judgment of its sponsors, the American Academy of Clinical Toxicology, the European Association of Poisons Centres and Clinical Toxicologists, the American Association of Poison Control Centers and the Asia Pacific Association of Medical Toxicology and, as such, is the leading international journal in the specialty.
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