Cargando…

Effects of smoking on delayed neuropsychiatric sequelae in acute carbon monoxide poisoning: A prospective observational study

Smoking is a well-known risk factor for cardio-cerebrovascular disease. However, several studies have reported the “smoker's paradox” whereby smokers have a better prognosis for cardio-cerebrovascular diseases. Similar to cardio-cerebrovascular diseases, hypoxia is one of the major mechanisms o...

Descripción completa

Detalles Bibliográficos
Autores principales: Nah, Sangun, Choi, Sungwoo, Lee, Sun-Uk, Kim, Gi Woon, Lee, Young Hwan, Han, Sangsoo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8137110/
https://www.ncbi.nlm.nih.gov/pubmed/34011113
http://dx.doi.org/10.1097/MD.0000000000026032
_version_ 1783695563109171200
author Nah, Sangun
Choi, Sungwoo
Lee, Sun-Uk
Kim, Gi Woon
Lee, Young Hwan
Han, Sangsoo
author_facet Nah, Sangun
Choi, Sungwoo
Lee, Sun-Uk
Kim, Gi Woon
Lee, Young Hwan
Han, Sangsoo
author_sort Nah, Sangun
collection PubMed
description Smoking is a well-known risk factor for cardio-cerebrovascular disease. However, several studies have reported the “smoker's paradox” whereby smokers have a better prognosis for cardio-cerebrovascular diseases. Similar to cardio-cerebrovascular diseases, hypoxia is one of the major mechanisms of injury in carbon monoxide (CO) poisoning. This study investigated the association between smoking and delayed neuropsychiatric sequelae (DNS) in acute CO poisoning. This study involved patients with CO poisoning treated at a university hospital in Bucheon, Korea between September 2017 and March 2020. The exclusion criteria were age <18 years, discharge against medical advice, loss to follow-up, persistent neurological symptoms at discharge, transfer from another hospital 24 hours after exposure, and transfer from another hospital after hyperbaric oxygen therapy. Logistic regression analysis was performed to find factors associated with DNS. Two hundred sixty three patients visited the hospital due to CO poisoning and of these, 54 were excluded. DNS was evaluated up to 3 months after discharge, and until this time, DNS occurred in 35 (16.8%) patients. And the incidence rate of DNS was lower in smokers than non-smokers (15, 12% vs 20, 23.8%, P = .040). Multivariable logistic regression analysis revealed that CO exposure time (odds ratio [OR] 1.003; confidence interval [CI] 1.001–1.005; P = .003), the Glasgow coma scale (GCS) (OR 0.862; CI 0.778–0.956; P = .005), and pack-years (OR 0.947; CI 0.903–0.993; P = .023) were statistically significant for DNS development. These results indicate that more pack-years smoked were associated with reduced risk of the development of DNS in acute CO poisoning, and that CO exposure time and GCS is a predictive factor for DNS occurrence.
format Online
Article
Text
id pubmed-8137110
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Lippincott Williams & Wilkins
record_format MEDLINE/PubMed
spelling pubmed-81371102021-05-25 Effects of smoking on delayed neuropsychiatric sequelae in acute carbon monoxide poisoning: A prospective observational study Nah, Sangun Choi, Sungwoo Lee, Sun-Uk Kim, Gi Woon Lee, Young Hwan Han, Sangsoo Medicine (Baltimore) 7200 Smoking is a well-known risk factor for cardio-cerebrovascular disease. However, several studies have reported the “smoker's paradox” whereby smokers have a better prognosis for cardio-cerebrovascular diseases. Similar to cardio-cerebrovascular diseases, hypoxia is one of the major mechanisms of injury in carbon monoxide (CO) poisoning. This study investigated the association between smoking and delayed neuropsychiatric sequelae (DNS) in acute CO poisoning. This study involved patients with CO poisoning treated at a university hospital in Bucheon, Korea between September 2017 and March 2020. The exclusion criteria were age <18 years, discharge against medical advice, loss to follow-up, persistent neurological symptoms at discharge, transfer from another hospital 24 hours after exposure, and transfer from another hospital after hyperbaric oxygen therapy. Logistic regression analysis was performed to find factors associated with DNS. Two hundred sixty three patients visited the hospital due to CO poisoning and of these, 54 were excluded. DNS was evaluated up to 3 months after discharge, and until this time, DNS occurred in 35 (16.8%) patients. And the incidence rate of DNS was lower in smokers than non-smokers (15, 12% vs 20, 23.8%, P = .040). Multivariable logistic regression analysis revealed that CO exposure time (odds ratio [OR] 1.003; confidence interval [CI] 1.001–1.005; P = .003), the Glasgow coma scale (GCS) (OR 0.862; CI 0.778–0.956; P = .005), and pack-years (OR 0.947; CI 0.903–0.993; P = .023) were statistically significant for DNS development. These results indicate that more pack-years smoked were associated with reduced risk of the development of DNS in acute CO poisoning, and that CO exposure time and GCS is a predictive factor for DNS occurrence. Lippincott Williams & Wilkins 2021-05-21 /pmc/articles/PMC8137110/ /pubmed/34011113 http://dx.doi.org/10.1097/MD.0000000000026032 Text en Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/)
spellingShingle 7200
Nah, Sangun
Choi, Sungwoo
Lee, Sun-Uk
Kim, Gi Woon
Lee, Young Hwan
Han, Sangsoo
Effects of smoking on delayed neuropsychiatric sequelae in acute carbon monoxide poisoning: A prospective observational study
title Effects of smoking on delayed neuropsychiatric sequelae in acute carbon monoxide poisoning: A prospective observational study
title_full Effects of smoking on delayed neuropsychiatric sequelae in acute carbon monoxide poisoning: A prospective observational study
title_fullStr Effects of smoking on delayed neuropsychiatric sequelae in acute carbon monoxide poisoning: A prospective observational study
title_full_unstemmed Effects of smoking on delayed neuropsychiatric sequelae in acute carbon monoxide poisoning: A prospective observational study
title_short Effects of smoking on delayed neuropsychiatric sequelae in acute carbon monoxide poisoning: A prospective observational study
title_sort effects of smoking on delayed neuropsychiatric sequelae in acute carbon monoxide poisoning: a prospective observational study
topic 7200
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8137110/
https://www.ncbi.nlm.nih.gov/pubmed/34011113
http://dx.doi.org/10.1097/MD.0000000000026032
work_keys_str_mv AT nahsangun effectsofsmokingondelayedneuropsychiatricsequelaeinacutecarbonmonoxidepoisoningaprospectiveobservationalstudy
AT choisungwoo effectsofsmokingondelayedneuropsychiatricsequelaeinacutecarbonmonoxidepoisoningaprospectiveobservationalstudy
AT leesunuk effectsofsmokingondelayedneuropsychiatricsequelaeinacutecarbonmonoxidepoisoningaprospectiveobservationalstudy
AT kimgiwoon effectsofsmokingondelayedneuropsychiatricsequelaeinacutecarbonmonoxidepoisoningaprospectiveobservationalstudy
AT leeyounghwan effectsofsmokingondelayedneuropsychiatricsequelaeinacutecarbonmonoxidepoisoningaprospectiveobservationalstudy
AT hansangsoo effectsofsmokingondelayedneuropsychiatricsequelaeinacutecarbonmonoxidepoisoningaprospectiveobservationalstudy