Effect of Carbon Monoxide Poisoning on Epilepsy Development: A Nationwide Population-Based Cohort Study

Meng, Yu-Hsiang; Hsieh, Ming-Shun; Chi, Yu-Chi; How, Chorng–Kuang; Chen, Pau‐Chung; Chang, Chia‐Ming

doi:10.1016/j.annemergmed.2022.11.021

Cited by 3 publications

(2 citation statements)

References 32 publications

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“…This finding is also consistent with prior evidence, which has demonstrated CO's neurotoxic effects 45 . A recent study also reported that patients with CO poisoning were 8.4 times more likely to develop epilepsy over the following 10 years than a comparison group without CO poisoning 46 . Heterogeneity between studies was low for this pooled estimate, indicating that this was a consistent finding across studies.…”

Section: Discussionsupporting

confidence: 90%

“…45 A recent study also reported that patients with CO poisoning were 8.4 times more likely to develop epilepsy over the following 10 years than a comparison group without CO poisoning. 46 Heterogeneity between studies was low for this pooled estimate, indicating that this was a consistent finding across studies. We also observed an increased risk for the lagged effect of 1 day, although it was not statistically significant (RR = 1.07, 95% CI = .98-1.17), which supports the conclusion that the 2-day lagged effect is unlikely to be statistically spurious.…”

Section: Discussionmentioning

confidence: 53%

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Association of outdoor air and noise pollution with unprovoked seizures and new onset epilepsy: A systematic review and meta‐analysis

Antaya,

Espino‐Alvarado,

Oiamo

et al. 2024

Epilepsia

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Research has indicated that certain environmental exposures may increase the risk of unprovoked seizures and new onset epilepsy. This study aimed to synthesize the literature that has estimated the associations between short‐ and long‐term exposure to outdoor air and noise pollution and the risk of unprovoked seizures and new onset epilepsy. We searched Embase, MEDLINE, Scopus, Web of Science, BIOSIS Previews, Latin American and Caribbean Health Sciences Literature, Proquest Dissertations and Theses, conference abstracts, and the gray literature and conducted citation tracing in June 2023. Observational and ecological studies assessing the associations of air and noise pollution with unprovoked seizures or new onset epilepsy were eligible. One reviewer extracted summary data. Using fixed and random effects models, we calculated the pooled risk ratios (RRs) for the studies assessing the associations between short‐term exposure to air pollution and unprovoked seizures. Seventeen studies were included, 16 assessing the association of air pollution with seizures and one with epilepsy. Eight studies were pooled quantitatively. Ozone (O3; RR = .99, 95% confidence interval [CI] = .99–.99) and nitrogen dioxide (NO2) exposure adjusted for particulate matter (RR = 1.02, 95% CI = 1.01–1.02) on the same day, and carbon monoxide (CO) exposure 2 days prior (RR = 1.12, 95% CI = 1.02–1.22), were associated with seizure risk. A single study of air pollution and epilepsy did not report a significant association. The risk of bias and heterogeneity across studies was moderate or high. Short‐term exposure to O3, NO2, and CO may affect the risk of seizures; however, the effect estimates for O3 and NO2 were minimal. Additional research should continue to explore these and the associations between outdoor air pollution and epilepsy and between noise pollution and seizures and epilepsy.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 53%

Association of outdoor air and noise pollution with unprovoked seizures and new onset epilepsy: A systematic review and meta‐analysis

Antaya,

Espino‐Alvarado,

Oiamo

et al. 2024

Epilepsia

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Carbon monoxide poisoning is associated with an increased risk of epilepsy and status epilepticus: a nationwide population-based cohort study conducted in the Republic of Korea between 2002–2021

Hwang,

Lee,

Kim

et al. 2024

Clinical Toxicology

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Mortality Risks and Causes in Previous Carbon Monoxide Poisoning: A Nationwide Population-Based Cohort Study

Ahn,

Lee,

Heo

et al. 2024

Critical Care Medicine

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Objectives: Carbon monoxide (CO) poisoning can cause brain, heart, and kidney injuries. We aimed to determine the association of risks of all-cause and cause-specific mortality in patients with previous CO poisoning. Design, Setting, and Patients: This population-based cohort study used data from the National Health Insurance Service database and the National Death Registry of Korea. Adult patients diagnosed with CO poisoning and controls between 2002 and 2020 were included. Patients were matched with controls on a 1:1 ratio, considering age, sex, insurance type, income level, residential location, smoking status, alcohol consumption, obesity status, medical and psychiatric illness history, and Charlson Comorbidity Index at the index date. The cohort was monitored from 2002 to 2022 or until death or emigration in terms of all-cause and cause-specific mortality. Interventions: None. Measurements and Main Results: A total of 48,600 patients with CO poisoning and matched controls were included. The cohort included 41.30% females, and the mean age was 48.05 years. Patients with CO poisoning exhibited a substantially elevated risk of all-cause mortality compared with those in the control group, with an adjusted hazard ratio (aHR) of 15.67 (95% CI, 12.58–19.51). The mortality associated with infectious (aHR, 6.71; 95% CI, 1.51–29.72), neoplasm/oncologic (aHR, 5.20; 95% CI, 3.39–7.99), endocrine (aHR, 13.44; 95% CI, 1.76–102.70), neurologic (aHR, 7.42; 95% CI, 2.91–18.90), cardiovascular (aHR, 8.97; 95% CI, 5.05–15.93), respiratory (aHR, 17.54; 95% CI, 5.48–56.17), and gastrointestinal (aHR, 24.72; 95% CI, 3.34–182.69) disorders was significantly greater in the former. Deaths due to external causes, including suicide, were significantly higher in the CO poisoning group (aHR, 50.07; 95% CI, 30.98–80.90). Conclusions: Patients with CO poisoning exhibited a heightened risk of all-cause mortality compared with the matched controls. Additionally, the cause-specific mortality risk differed between the groups.

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Effect of Carbon Monoxide Poisoning on Epilepsy Development: A Nationwide Population-Based Cohort Study

Cited by 3 publications

References 32 publications

Association of outdoor air and noise pollution with unprovoked seizures and new onset epilepsy: A systematic review and meta‐analysis

Association of outdoor air and noise pollution with unprovoked seizures and new onset epilepsy: A systematic review and meta‐analysis

Carbon monoxide poisoning is associated with an increased risk of epilepsy and status epilepticus: a nationwide population-based cohort study conducted in the Republic of Korea between 2002–2021

Mortality Risks and Causes in Previous Carbon Monoxide Poisoning: A Nationwide Population-Based Cohort Study

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