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Open AccessArticle

Impact of Hyperbaric Oxygen Therapy on Subsequent Neurological Sequelae Following Carbon Monoxide Poisoning

1
Department of Emergency Medicine, Chi-Mei Medical Center, Tainan 710, Taiwan
2
Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
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Department of Senior Services, Southern Taiwan University of Science and Technology, Tainan 71005, Taiwan
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Department of Medical Research, Chi Mei Medical Center, Tainan 710, Taiwan
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Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan 71710, Taiwan
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Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan 71005, Taiwan
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Department of Leisure, Recreation and Tourism Management, Southern Taiwan University of Science and Technology, Tainan 71005, Taiwan
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Department of Emergency Medicine, Taipei Medical University, Taipei 110, Taiwan
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Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan 704, Taiwan
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Occupational Safety, Health, and Health Research Center, National Cheng Kung University Hospital, Tainan 704, Taiwan
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2018, 7(10), 349; https://doi.org/10.3390/jcm7100349
Received: 18 September 2018 / Revised: 9 October 2018 / Accepted: 11 October 2018 / Published: 13 October 2018
(This article belongs to the Section Clinical Neurology)
The purpose of this study was to evaluate the effects of hyperbaric oxygen therapy (HBOT) on reducing neurological sequelae (NS) in patients with carbon monoxide poisoning (COP). Using a nationwide database of insurance claims in Taiwan, we conducted a population-based cohort study to identify 24,046 patients with COP diagnosed between 1999 and 2012, including 6793 (28.2%) patients who received HBOT and 17,253 (71.8%) patients who did not. We followed the two cohorts of patients and compared the occurrence of NS. The two cohorts had similar sex ratios, but patients who received HBOT were younger (34.8 ± 14.8 vs. 36.1 ± 17.2 years, p < 0.001). Patients who received HBOT had a higher risk for NS (adjusted hazard ratio [AHR]: 1.4; 95% confidence interval [CI]: 1.4–1.5), after adjusting for age, sex, underlying comorbidities (hypertension, diabetes, chronic obstructive pulmonary disease, hyperlipidemia, malignancy, coronary artery disease, congestive heart failure, liver disease, renal disease, connective tissue disease, human immunodeficiency virus [HIV] infection, and alcoholism), monthly income, suicide, drug poisoning, and acute respiratory failure. We observed similar findings when we stratified the patients by age, sex, underlying comorbidities, and monthly income. The increased risk was most prominent in the first 2 weeks (AHR: 2.4; 95% CI: 2.1–2.7) and remained significant up to 6 months later (AHR: 1.6; 95% CI: 1.4–1.7). The risk for NS was higher in patients with COP who received HBOT than in those who did not, even after considering the possible impact of longer observation periods on survivors. Further studies that included the potential confounding factors we did not measure are needed to confirm findings in this study. View Full-Text
Keywords: carbon monoxide poisoning; hyperbaric oxygen therapy; neurological sequelae carbon monoxide poisoning; hyperbaric oxygen therapy; neurological sequelae
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MDPI and ACS Style

Huang, C.-C.; Ho, C.-H.; Chen, Y.-C.; Hsu, C.-C.; Wang, Y.-F.; Lin, H.-J.; Wang, J.-J.; Guo, H.-R. Impact of Hyperbaric Oxygen Therapy on Subsequent Neurological Sequelae Following Carbon Monoxide Poisoning. J. Clin. Med. 2018, 7, 349.

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