Objective To analyze the incidence patterns of nervous system diseases in survivors of carbon monoxide (CO) poisoning using nationwide claims data from South Korea.
Methods A national cohort was abstracted from a database that includes patients diagnosed with CO poisoning between January 2012 and December 2018. For all nervous system diseases, we investigated the frequency, pattern of incidence, effect of intensive care unit admission, and the standardized incidence ratios (SIRs) to estimate the risk of nervous system disease after CO poisoning.
Results Of 26,778 patients, 18,720 (69.9%) were diagnosed with nervous system diseases after CO poisoning. The most common disease was disorders of sleep initiation and maintenance (n=701, 3.74%), followed by tension-type headache (n=477, 2.55%) and anoxic brain injury (n=406, 2.17%). Over half of the nervous system diseases occurred within the first year after CO poisoning. The cumulative hazard ratio for nervous system diseases in patients admitted to the intensive care unit was 2.25 (95% confidence interval [CI], 2.07–2.44). Among the frequent nervous system diseases after CO poisoning, patients had a higher risk of disorders of initiating and maintaining sleep (SIR, 1.61; 95% CI, 1.52–1.71), tension-type headache (SIR, 2.41; 95% CI, 2.23–2.61), anoxic brain injury (SIR, 58.76; 95% CI, 53.95–63.88), and post-zoster neuralgia (SIR, 1.94; 95% CI, 1.70–2.20).
Conclusion Patients who experience CO poisoning are at higher risk for several nervous system diseases. Therefore, monitoring for specific nervous system diseases is important after CO poisoning within the first year.
Citations
Citations to this article as recorded by
A double-blind randomized trial of hyperbaric oxygen for persistent symptoms after brain injury Lindell K. Weaver, Rosemary Ziemnik, Kayla Deru, Antonietta A. Russo Scientific Reports.2025;[Epub] CrossRef
Machine Learning–Based Prediction of Delayed Neurologic Sequelae in Carbon Monoxide Poisoning Using Automatically Extracted MR Imaging Features Grace Yoojin Lee, Chang Hwan Sohn, Dongwon Kim, Sang-Beom Jeon, Jihye Yun, Sungwon Ham, Yoojin Nam, Jieun Yum, Won Young Kim, Namkug Kim American Journal of Neuroradiology.2025; 46(12): 2645. CrossRef
Characteristics and toxicity of burning smoke released from non-metallic materials of ships in a closed environment Jing Yang, Zhi Li, Xun Liu, Xiaomeng Ren, Jun Wu, Xinhong Xu, Xiaochen Bao, Lu Jiang, Jingjing Fang Journal of Hazardous Materials.2024; 480: 136109. CrossRef
Long-term mortality of adult patients with carbon monoxide poisoning presenting to the emergency department in Korea: a population-based cohort study Sang Hwan Lee, Soo Rack Ryu, Kyung Hun Yoo, Juncheol Lee, Yongil Cho, Tae Ho Lim, Hyunggoo Kang, Jaehoon Oh, Byuk Sung Ko Acute and Critical Care.2024; 39(4): 526. CrossRef
Prevalence of Carbon Monoxide Poisoning and Hyperbaric Oxygen Therapy in Korea: Analysis of National Claims Data in 2010–2019 Eunah Han, Gina Yu, Hye Sun Lee, Goeun Park, Sung Phil Chung Journal of Korean Medical Science.2023;[Epub] CrossRef
Predicting acute brain lesions on magnetic resonance imaging in acute carbon monoxide poisoning: a multicenter prospective observational study Kyung Hun Yoo, Hyunggoo Kang, Jaehoon Oh, Tae Ho Lim, Yongil Cho, Juncheol Lee, Sang Hwan Lee, Seungkyo Jung, Won Young Kim, Chang Hwan Sohn, Byuk Sung Ko Scientific Reports.2023;[Epub] CrossRef
Level of knowledge about carbon monoxide poisoning and its prevention among students of the Medical School of the Universidad Abierta Interamericana of the city of Rosario (Argentina) in the year 2023 Sofía Bonardi, Rodolfo Verrone Health Leadership and Quality of Life.2023; 2: 68. CrossRef
Prevalence of Acute Myocardial and Brain Toxicity in Emergency Department Patients Exposed to Carbon Monoxide Carolina Zúñiga, Luisa Fabiola Pérez Moreno, Shirley Liperguer, Verónica Torres Cerino Open Journal of Emergency Medicine.2023; 11(04): 198. CrossRef
Tips for avoiding common mistakes in out-of-hospital diagnosis of carbon monoxide poisoning G. Fucili, M. Brauzzi Journal of Anesthesia, Analgesia and Critical Care.2022;[Epub] CrossRef
Carbon Monoxide Poisoning was Associated With Lifetime Suicidal Ideation: Evidence From A Population-Based Cross-Sectional Study in Hebei Province, China Long Sun, Keqing Li, Yunshu Zhang, Lili Zhang International Journal of Public Health.2022;[Epub] CrossRef
Prognostic value of the myeloperoxidase index for early prediction of neurologic outcome in acute carbon monoxide poisoning Joong Seok Moon, Sung Hwa Kim, Yong Sung Cha Clinical and Experimental Emergency Medicine.2022; 9(3): 230. CrossRef
Serum phosphate is not an early predictor of neurocognitive outcomes in acute carbon monoxide poisoning patients Yuseon Lee, Sung Hwa Kim, Yong Sung Cha Clinical and Experimental Emergency Medicine.2022; 10(1): 74. CrossRef
Objective We aimed to analyze the differences in epidemiological aspects and clinical courses of acute poisonings in each region of the Gyeonggi-do province in Korea.
Methods This retrospective study analyzed data from the National Emergency Department Information System of Korea. We retrospectively reviewed cases of acute poisonings between April 2006 and March 2015 recorded at 13 emergency departments in eight different cities of Gyeonggi-do province in Korea. The differences in the incidence, age distribution, causative agent, and clinical course of poisonings among regions were the main outcomes measured.
Results The proportion of poisonings in the ≤9 age group was high in Yongin (17.44%) and that in ≥65 age group was high in Gwangmyeong (21.76%). The proportion of cases involving carbon monoxide was high in Ansan (8.82%) in patients hospitalized and the proportion of cases involving pesticides was high in Pyeongtaek (52.78%) in patients admitted to the intensive care unit. The admission rate of poisoned patients was high in Osan (36.02%).
Conclusion In this study, differences in the characteristics of poisoned patients between 8 cities were noted. Therefore, hospitals need to arrange treatment resources for poisoned patients according to the characteristics of the specific region. The results of this study may serve as evidence for new strategies to prepare for the acute poisonings in hospitals.
Citations
Citations to this article as recorded by
A four-way patient search method for the retrospective identification of poisoning patients Veronika Uslin, Ville Hällberg, Timo Lukkarinen, Marjo Niskanen, Teemu Koivistoinen, Ari Palomäki Scientific Reports.2024;[Epub] CrossRef
Clinical support system for triage based on federated learning for the Korea triage and acuity scale Hansol Chang, Jae Yong Yu, Geun Hyeong Lee, Sejin Heo, Se Uk Lee, Sung Yeon Hwang, Hee Yoon, Won Chul Cha, Tae Gun Shin, Min Seob Sim, Ik Joon Jo, Taerim Kim Heliyon.2023; 9(8): e19210. CrossRef
Characterization of Acute Poisoning in Hospitalized Children in Southwest China Zhu Li, Li Xiao, Lin Yang, Shaojun Li, Liping Tan Frontiers in Pediatrics.2021;[Epub] CrossRef
Development of a Mobile Personal Health Record Application Designed for Emergency Care in Korea; Integrated Information from Multicenter Electronic Medical Records Yuri Choi, June-sung Kim, In Ho Kwon, Taerim Kim, Su Min Kim, Wonchul Cha, Jinwoo Jeong, Jae-Ho Lee Applied Sciences.2020; 10(19): 6711. CrossRef
Frequency and Management of Acute Poisoning Among Children Attending an Emergency Department in Saudi Arabia Mansour Tobaiqy, Bandar A. Asiri, Ahmed H. Sholan, Yahya A. Alzahrani, Ayed A. Alkatheeri, Ahmed M. Mahha, Shamsia S. Alzahrani, Katie MacLure Pharmacy.2020; 8(4): 189. CrossRef
Objective This study aimed to analyze intracranial vessels using brain computed tomography angiography (CTA) and scoring systems to diagnose brain death and predict poor neurologic outcomes of postcardiac arrest patients.
Methods Initial brain CTA images of postcardiac arrest patients were analyzed using scoring systems to determine a lack of opacification and diagnose brain death. The primary outcome was poor neurologic outcome, which was defined as cerebral performance category score 3 to 5. The frequency, sensitivity, specificity, positive predictive value, negative predictive value, and area under receiver operating characteristic curve for the lack of opacification of each vessel and for each scoring system used to predict poor neurologic outcomes were determined.
Results Patients with poor neurologic outcomes lacked opacification of the intracranial vessels, most commonly in the vein of Galen, both internal cerebral veins, and the mid cerebral artery (M4). The 7-score results (P=0.04) and 10-score results were significantly different (P=0.04) between outcome groups, with an area under receiver operating characteristic of 0.61 (range, 0.48 to 0.72). The lack of opacification of each intracranial vessel and all scoring systems exhibited high specificity (100%) and positive predictive values (100%) for predicting poor neurologic outcomes.
Conclusion Lack of opacification of vessels on brain CTA exhibited high specificity for predicting poor neurologic outcomes of patients after cardiac arrest.
Citations
Citations to this article as recorded by
Prognostic value of machine learning for brain computed tomography as a predictor of neurologic outcomes after cardiac arrest: a systematic review and meta-analysis Kyung Hun Yoo, Juncheol Lee, Wonhee Kim, Bitnarae Kim, Elleah Jueun Chin, Jae-Guk Kim, Hyun-Young Choi, Jaehoon Oh Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.2026;[Epub] CrossRef
Taking a New SLANT on Postcardiac Arrest Prognostication?* Neha S. Dangayach, Brian J. Wright Critical Care Medicine.2022; 50(3): 519. CrossRef
Objective Cerebral hemodynamic and metabolic changes may occur during the rewarming phase of targeted temperature management in post cardiac arrest patients. Yet, studies on different rewarming rates and patient outcomes are limited. This study aimed to investigate post cardiac arrest patients who were rewarmed with different rewarming rates after 24 hours of hypothermia and the association of these rates to the neurologic outcomes.
Methods This study retrospectively investigated post cardiac arrest patients treated with targeted temperature management and rewarmed with rewarming rates of 0.15°C/hr and 0.25°C/hr. The association of the rewarming rate with poor neurologic outcomes (cerebral performance category score, 3 to 5) was investigated.
Results A total of 71 patients were analyzed (0.15°C/hr, n=36; 0.25°C/hr, n=35). In the comparison between 0.15°C/hr and 0.25°C/hr, the poor neurologic outcome did not significantly differ (24 [66.7%] vs. 25 [71.4%], respectively; P=0.66). In the multivariate analysis, the rewarming rate of 0.15°C/hr was not associated with the 1-month neurologic outcome improvement (odds ratio, 0.54; 95% confidence interval, 0.16 to 1.69; P=0.28).
Conclusion The rewarming rates of 0.15°C/hr and 0.25°C/hr were not associated with the neurologic outcome difference in post cardiac arrest patients.
Citations
Citations to this article as recorded by
Association Between Rewarming Rate and Survival and Neurologic Outcome of Accidental Hypothermia Chiaki Hara, Takuya Taira, Akihiko Inoue, Takeshi Nishimura, Shota Kikuta, Nobuhiro Yamamoto, Shinichi Ijuin, Shuhei Takauji, Mineji Hayakawa, Satoshi Ishihara Critical Care Medicine.2025; 53(7): e1416. CrossRef
Temperature Control After Cardiac Arrest: A Narrative Review Samantha Fernandez Hernandez, Brooke Barlow, Vera Pertsovskaya, Carolina B. Maciel Advances in Therapy.2023; 40(5): 2097. CrossRef
Rapid rewarming rate associated with favorable neurological outcomes in patients with post–cardiac arrest syndrome patients treated with targeted temperature management Masaru Shin, Motoki Fujita, Toru Hifumi, Yasutaka Koga, Takeshi Yagi, Takashi Nakahara, Masaki Todani, Kotaro Kaneda, Ryosuke Tsuruta Acute Medicine & Surgery.2023;[Epub] CrossRef
Targeted Temperature Management After Cardiac Arrest Nicole Kupchik Critical Care Nursing Clinics of North America.2021; 33(3): 303. CrossRef
Impact of rewarming rate on interleukin-6 levels in patients with shockable cardiac arrest receiving targeted temperature management at 33 °C: the ISOCRATE pilot randomized controlled trial Jean-Baptiste Lascarrou, Elie Guichard, Jean Reignier, Amélie Le Gouge, Caroline Pouplet, Stéphanie Martin, Jean-Claude Lacherade, Gwenhael Colin, M. Azais, K. Bachoumas, A. Bailly, L. Camous, G. Colin, L. Crosby, M. Fiancette, M. Henry Lagarrigue, J. C. Critical Care.2021;[Epub] CrossRef
Rewarming: The neglected phase of targeted temperature management Niklas Nielsen, Hans Kirkegaard Resuscitation.2020; 146: 249. CrossRef
High Quality Targeted Temperature Management (TTM) After Cardiac Arrest Fabio Silvio Taccone, Edoardo Picetti, Jean-Louis Vincent Critical Care.2020;[Epub] CrossRef
Resuscitating the Globally Ischemic Brain: TTM and Beyond Melika Hosseini, Robert H. Wilson, Christian Crouzet, Arya Amirhekmat, Kevin S. Wei, Yama Akbari Neurotherapeutics.2020; 17(2): 539. CrossRef
A practical approach to the use of targeted temperature management after cardiac arrest Filippo Annoni, Katia Donadello, Leda Nobile, Fabio S. Taccone Minerva Anestesiologica.2020;[Epub] CrossRef
First
Prev
