2
|
Huang CC, Ho CH, Chen YC, Hsu CC, Wang YF, Lin HJ, Wang JJ, Guo HR. Impact of Hyperbaric Oxygen Therapy on Subsequent Neurological Sequelae Following Carbon Monoxide Poisoning. J Clin Med 2018; 7:jcm7100349. [PMID: 30322113 PMCID: PMC6211110 DOI: 10.3390/jcm7100349] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 10/09/2018] [Accepted: 10/11/2018] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study was to evaluate the effects of hyperbaric oxygen therapy (HBOT) on reducing neurological sequelae (NS) in patients with carbon monoxide poisoning (COP). Using a nationwide database of insurance claims in Taiwan, we conducted a population-based cohort study to identify 24,046 patients with COP diagnosed between 1999 and 2012, including 6793 (28.2%) patients who received HBOT and 17,253 (71.8%) patients who did not. We followed the two cohorts of patients and compared the occurrence of NS. The two cohorts had similar sex ratios, but patients who received HBOT were younger (34.8 ± 14.8 vs. 36.1 ± 17.2 years, p < 0.001). Patients who received HBOT had a higher risk for NS (adjusted hazard ratio [AHR]: 1.4; 95% confidence interval [CI]: 1.4⁻1.5), after adjusting for age, sex, underlying comorbidities (hypertension, diabetes, chronic obstructive pulmonary disease, hyperlipidemia, malignancy, coronary artery disease, congestive heart failure, liver disease, renal disease, connective tissue disease, human immunodeficiency virus [HIV] infection, and alcoholism), monthly income, suicide, drug poisoning, and acute respiratory failure. We observed similar findings when we stratified the patients by age, sex, underlying comorbidities, and monthly income. The increased risk was most prominent in the first 2 weeks (AHR: 2.4; 95% CI: 2.1⁻2.7) and remained significant up to 6 months later (AHR: 1.6; 95% CI: 1.4⁻1.7). The risk for NS was higher in patients with COP who received HBOT than in those who did not, even after considering the possible impact of longer observation periods on survivors. Further studies that included the potential confounding factors we did not measure are needed to confirm findings in this study.
Collapse
Affiliation(s)
- Chien-Cheng Huang
- Department of Emergency Medicine, Chi-Mei Medical Center, Tainan 710, Taiwan.
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan.
- Department of Senior Services, Southern Taiwan University of Science and Technology, Tainan 71005, Taiwan.
| | - Chung-Han Ho
- Department of Medical Research, Chi Mei Medical Center, Tainan 710, Taiwan.
- Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan 71710, Taiwan.
| | - Yi-Chen Chen
- Department of Medical Research, Chi Mei Medical Center, Tainan 710, Taiwan.
| | - Chien-Chin Hsu
- Department of Emergency Medicine, Chi-Mei Medical Center, Tainan 710, Taiwan.
- Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan 71005, Taiwan.
| | - Yi-Fong Wang
- Department of Leisure, Recreation and Tourism Management, Southern Taiwan University of Science and Technology, Tainan 71005, Taiwan.
| | - Hung-Jung Lin
- Department of Emergency Medicine, Chi-Mei Medical Center, Tainan 710, Taiwan.
- Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan 71005, Taiwan.
- Department of Emergency Medicine, Taipei Medical University, Taipei 110, Taiwan.
| | - Jhi-Joung Wang
- Department of Medical Research, Chi Mei Medical Center, Tainan 710, Taiwan.
| | - How-Ran Guo
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan.
- Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan 704, Taiwan.
- Occupational Safety, Health, and Health Research Center, National Cheng Kung University Hospital, Tainan 704, Taiwan.
| |
Collapse
|
3
|
Juurlink DN, Buckley NA, Eddleston M. Better Studies Are Needed to Guide Treatment of Carbon Monoxide Poisoning. Am J Respir Crit Care Med 2017; 195:694. [PMID: 28248145 DOI: 10.1164/rccm.201611-2255le] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|