Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea.
Biostatistical Consulting and Research Laboratory, Medical Research Collaborating Center, Hanyang University, Seoul, Republic of Korea.
Ann Emerg Med. 2020 May;75(5):587-596. doi: 10.1016/j.annemergmed.2019.08.454. Epub 2019 Nov 20.
Few studies have investigated the association between carbon monoxide (CO) poisoning and risk of venous thromboembolism. We aim to identify the risk of pulmonary embolism and deep venous thrombosis after CO poisoning.
We conducted a nationwide cohort-crossover study using administrative claims data in Korea. We compared the risk of venous thromboembolism (pulmonary embolism or deep venous thrombosis) in the cohort period after CO poisoning to that of the same period 1 year later (crossover period), using conditional logistic regression analysis.
We included 22,699 patients with a diagnosis of CO poisoning during the study period between 2004 and 2015. The risk of venous thromboembolism was significantly elevated during days 0 to 90 after CO poisoning (odds ratio 3.96; 95% confidence interval 2.50 to 6.25). However, this risk was not significantly elevated during subsequent postexposure periods through 360 days. During days 0 to 30 after CO poisoning, the risks of pulmonary embolism (odds ratio 22.00; 95% confidence interval 5.33 to 90.75) and deep venous thrombosis (odds ratio 10.33; 95% confidence interval 3.16 to 33.80) were significantly elevated.
We found that the risk of venous thromboembolism persisted for up to 90 days after CO poisoning. The risk was increased 22-fold for pulmonary embolism and 10-fold for deep venous thrombosis, especially in the first month after CO poisoning. Patients should be monitored for venous thromboembolism risk after CO poisoning.
鲜有研究调查一氧化碳（CO）中毒与静脉血栓栓塞风险之间的关联。我们旨在确定 CO 中毒后发生肺栓塞和深静脉血栓的风险。
我们使用韩国的行政索赔数据进行了一项全国性的队列交叉研究。我们使用条件逻辑回归分析，将 CO 中毒后队列期（CO 中毒后）与同期（交叉期）的静脉血栓栓塞（肺栓塞或深静脉血栓形成）风险进行比较。
我们纳入了 2004 年至 2015 年期间患有 CO 中毒诊断的 22699 名患者。CO 中毒后 0 至 90 天内静脉血栓栓塞的风险显著升高（优势比 3.96；95%置信区间 2.50 至 6.25）。然而，在随后的暴露后 360 天内，这种风险并未显著升高。在 CO 中毒后 0 至 30 天内，肺栓塞（优势比 22.00；95%置信区间 5.33 至 90.75）和深静脉血栓形成（优势比 10.33；95%置信区间 3.16 至 33.80）的风险显著升高。
我们发现 CO 中毒后静脉血栓栓塞的风险持续长达 90 天。肺栓塞的风险增加了 22 倍，深静脉血栓形成的风险增加了 10 倍，尤其是在 CO 中毒后的第一个月。患者在 CO 中毒后应监测静脉血栓栓塞风险。
