title: Long-term prognosis of patients with carbon monoxide poisoning: a nationwide cohort study.
abstract: BACKGROUND
  Carbon monoxide poisoning (COP) often produces severe complications and can be fatal. Because this topic has not been well delineated, we investigated long-term prognoses of patients with COP (COP[+]).
  
  
  METHODS
  In this retrospective nationwide cohort study, 441 COP[+] patients and 8820 COP[-] controls (120) from 1999 to 2010 were selected from Taiwan's National Health Insurance Research Database.
  
  
  RESULTS
  Thirty-seven (8.39%) COP[+] patients and 142 (1.61%) controls died (P<0.0001) during follow-up. Incidence rate ratios (IRR) of death were 5.24 times higher in COP[+] patients than in controls (P<0.0001). The risk of death was particularly high in the first month after COP (IRR: 308.78; 95% confidence interval [CI]: 40.79-2337.56), 1 to 6 months after (IRR: 18.92; 95% CI: 7.69-46.56), and 6-12 months after (IRR: 4.73; 95% CI: 1.02-21.90). After adjusting for age, gender, and selected comorbidities, the hazard ratio of death for COP[+] patients was still 4.097 times higher than for controls. Moreover, older age (≥30 years old), male gender, diabetes mellitus, hypertension, and low income were also independent mortality predictors.
  
  
  CONCLUSIONS
  COP significantly increases the risk for long-term mortality. Early follow-up and secondary prevention of death are needed for patients with COP.
authors.affiliation: Department of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan; Department of Child Care and Education, Southern Taiwan University of Science and Technology, Tainan, Taiwan; Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Emergency Medicine, Kuo General Hospital, Tainan, Taiwan.
authors.forename: Chien-Cheng
authors.initials: CC
authors.lastname: Huang
authors.affiliation: Department of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan; Department of Emergency Medicine, Chi-Mei Medical Center, Liouying, Tainan, Taiwan.
authors.forename: Min-Hsien
authors.initials: MH
authors.lastname: Chung
authors.affiliation: Departments of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan.
authors.forename: Shih-Feng
authors.initials: SF
authors.lastname: Weng
authors.affiliation: Department of Nephrology, Chi-Mei Medical Center, Tainan, Taiwan; Department of Food Nutrition, Chung Hwa University of Medical Technology, Tainan, Taiwan.
authors.forename: Chih-Chiang
authors.initials: CC
authors.lastname: Chien
authors.affiliation: Department of Pediatrics, Chi-Mei Medical Center, Tainan, Taiwan.
authors.forename: Shio-Jean
authors.initials: SJ
authors.lastname: Lin
authors.affiliation: Department of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan; Department of Emergency Medicine, Taipei Medical University, Taipei, Taiwan; Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan, Taiwan.
authors.forename: Hung-Jung
authors.initials: HJ
authors.lastname: Lin
authors.affiliation: Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.
authors.forename: How-Ran
authors.initials: HR
authors.lastname: Guo
authors.affiliation: Department of Occupational Medicine, Chi-Mei Medical Center, Tainan, Taiwan; Department of Leisure, Recreation and Tourism Management, Southern Taiwan University of Science and Technology, Tainan, Taiwan; Department of Medical Research, Chi Mei Medical Center, Liouying, Tainan, Taiwan.
authors.forename: Shih-Bin
authors.initials: SB
authors.lastname: Su
authors.affiliation: Department of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan; Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan, Taiwan.
authors.forename: Chien-Chin
authors.initials: CC
authors.lastname: Hsu
authors.affiliation: Department of Emergency Medicine, Kuang-Tien General Hospital, Taichung, Taiwan; Department of Nursing, Hungkuang University, Taichung, Taiwan.
authors.forename: Chi-Wen
authors.initials: CW
authors.lastname: Juan
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002249:Carbon Monoxide Poisoning / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult