Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Emergency Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Department of Emergency Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Emergency Medicine, Taipei Veterans General Hospital Taoyuan Branch, Taoyuan, Taiwan.
Ann Emerg Med. 2023 Aug;82(2):145-151. doi: 10.1016/j.annemergmed.2022.11.021. Epub 2023 Feb 15.
Carbon monoxide (CO) poisoning causes central nervous system toxicity resulting in delayed neurologic sequelae. This study aims to evaluate the risk of epilepsy in patients with a history of CO intoxication.
We conducted a retrospective population-based cohort study using the Taiwan National Health Insurance Research Database and enrolled patients with and without CO poisoning matched for age, sex, and index year in a 1:5 ratio, between 2000 and 2010. Multivariable survival models were used to assess the risk of epilepsy. The primary outcome was newly developed epilepsy after the index date. All patients were followed until a new diagnosis of epilepsy, death, or December 31, 2013. Stratification analyses by age and sex were also conducted.
This study included 8,264 patients with CO poisoning and 41,320 without. Patients with a history of CO poisoning were strongly associated with subsequent epilepsy (adjusted hazard ratio [HR] 8.40; 95% confidence interval [CI], 6.48 to 10.88). In the age-stratified analysis, intoxicated patients aged 20 to 39 years had the highest HR (adjusted HR 11.06; 95% CI, 7.17 to 17.08). In the sex-stratified analysis, adjusted HRs for male and female patients were 8.00 (95% CI, 5.86 to 10.92) and 9.53 (95% CI, 5.95 to 15.26), respectively.
Patients with CO poisoning were associated with an increased risk of developing epilepsy compared with those without CO poisoning. This association was more prominent in the young population.
一氧化碳（CO）中毒会导致中枢神经系统毒性，从而导致迟发性神经后遗症。本研究旨在评估有 CO 中毒史患者发生癫痫的风险。
我们使用台湾全民健康保险研究数据库进行了一项回顾性基于人群的队列研究，在 2000 年至 2010 年期间，将年龄、性别和指数年份相匹配的有和无 CO 中毒史的患者按照 1:5 的比例纳入研究。使用多变量生存模型评估癫痫的发病风险。主要结局为指数日期后新发生的癫痫。所有患者均随访至新诊断为癫痫、死亡或 2013 年 12 月 31 日。还进行了按年龄和性别分层的分析。
本研究共纳入 8264 例 CO 中毒患者和 41320 例无 CO 中毒患者。有 CO 中毒史的患者与随后发生癫痫密切相关（调整后的危险比 [HR] 8.40；95%置信区间 [CI]，6.48 至 10.88）。在年龄分层分析中，20 至 39 岁中毒患者的 HR 最高（调整后的 HR 11.06；95% CI，7.17 至 17.08）。在性别分层分析中，男性和女性患者的调整后 HR 分别为 8.00（95% CI，5.86 至 10.92）和 9.53（95% CI，5.95 至 15.26）。
与无 CO 中毒史的患者相比，CO 中毒患者发生癫痫的风险增加。这种关联在年轻人群中更为显著。
