# Relationship Between Cardiovascular Disease Risk and Long-Term Neurological Sequelae After Carbon Monoxide Poisoning: A Nationwide Cohort Study

## TL;DR

This study finds that carbon monoxide poisoning is linked to higher risks of cardiovascular disease and long-term neurological issues, with increased mortality compared to the general population.

## Contribution

The study reveals a strong association between COP and long-term neurological and cardiovascular complications using a nationwide cohort.

## Key findings

- COP patients with CVD history had significantly higher rates of persistent neurological sequelae.
- COP patients without CVD history had increased delayed neurological sequelae.
- COP patients had 7.40 times higher mortality compared to the general population.

## Abstract

Background: Carbon monoxide poisoning (COP) has emerged as a significant health issue in Asian countries, including Taiwan. It poses serious risks, including long-term complications such as cardiovascular disease (CVD), neurological disorders, and even death. This study investigated the association of COP with the development of cardiovascular diseases and neurological sequelae, while evaluating all-cause and cause-specific mortality as secondary outcomes. Methods: This retrospective study utilized the National Health Insurance Research Database and included the patients aged ≥ 20 years hospitalized with a COP diagnosis between 1 January 2000 and 31 December 2015. The objective was to investigate long-term neurological complications, CVD (such as ischemic heart disease and other cardiac conditions), and associated risk factors. Cox proportional hazard regression was employed to analyze differences in long-term neurological sequelae and cardiovascular outcomes among various groups. Results: A total of 2421 COP patients were enrolled. COP patients with CVD history had a higher incidence of persistent neurological sequelae (PNS) in two different diagnostic codes (8.6%, p < 0.001 and 11.5%, p = 0.018), but COP patients without CVD history had a higher incidence of delayed neurological sequelae (DNS) only in one of the diagnostic codes (6.8%, p < 0.001). The risk from CVD factor was up to 11.92 times. Furthermore, the overall mortality was 8.8%, which is significantly higher than 3.7% in the general population. After adjusting for other factors, the mortality in COP individuals was 7.40 times higher than that of the general population. Conclusions: Patients with COP might be at high risk of developing CVD and have a significantly increased risk of CVD. COP is associated with a higher risk of long-term neurological complications and an increased incidence of CVD. These findings help mitigate the potential long-term health impacts of COP.