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Association between ischemic stroke and carbon monoxide poisoning: A population-based retrospective cohort analysis

  • Chia-Wei Lin
    Affiliations
    Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
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  • Wei-Kung Chen
    Affiliations
    Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
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  • Dong-Zong Hung
    Affiliations
    Division of Toxicology & Emergency Center, Medical University Hospital, Taichung, Taiwan
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  • Yi-Wen Chen
    Affiliations
    Department of Neurology, Cheng Ching General Hospital, Taichung, Taiwan
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  • Cheng-Li Lin
    Affiliations
    Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan

    College of Medicine, China Medical University, Taichung, Taiwan
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  • Author Footnotes
    1 Sung FC and Kao CH have equal contribution.
    Fung-Chang Sung
    Footnotes
    1 Sung FC and Kao CH have equal contribution.
    Affiliations
    Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan

    Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
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  • Author Footnotes
    1 Sung FC and Kao CH have equal contribution.
    Chia-Hung Kao
    Correspondence
    Corresponding author at: Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung 40447, Taiwan. Tel.: +886 4 22052121x7412; fax: +886 4 22336174.
    Footnotes
    1 Sung FC and Kao CH have equal contribution.
    Affiliations
    Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan

    Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan
    Search for articles by this author
  • Author Footnotes
    1 Sung FC and Kao CH have equal contribution.
Published:December 16, 2015DOI:https://doi.org/10.1016/j.ejim.2015.11.025

      Highlights

      • Increased cumulative incidence of ischemic stroke in the CO-poisoning cohort.
      • The CO-poisoning relative risk was greatest in the youngest group (20–34 years).
      • The relative risk of ischemic stroke was approximately 2.60-fold.

      Abstract

      Background

      The long-term consequence of cardiovascular health has not been evaluated for patients with carbon monoxide (CO) poisoning. This study evaluated the risk of ischemic stroke using population-based data.

      Methods

      We identified 8705 inpatients with CO intoxication diagnosed from 2000 to 2011 from the Taiwan National Health Insurance Research Database. The control cohort consisted of 34,820 persons randomly identified from patients without exposure frequency matched by age, sex, and the year of hospitalization. Incidence and hazard ratio (HR) of ischemic stroke were evaluated by sociodemographic factors and comorbidities by the end of 2011.

      Results

      The incidence of ischemic stroke revealed a significant increase in the CO-poisoning cohort over the follow-up period (p < 0.001). The overall incidence of ischemic stroke was near 2.5-fold greater in the CO-poisoned cohort than in controls (5.49 versus 2.02 per 1000 person-years), with an adjusted HR of 2.60 (95% confidence interval (CI) = 2.15–3.15). The adjusted HR for those without comorbidities was slightly higher (2.76, 95% CI = 2.13–3.58). The age-specific CO-poisoning to non-CO-poisoning relative risk was greatest in the youngest group (20–34 years) (adjusted HR = 6.45; 95% CI = 3.30–12.6).

      Conclusion

      CO poisoning is associated with a long-term risk of increased incident ischemic stroke. Further study on the mechanism of ischemic stroke for CO poisoning affects is needed.

      Keywords

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