Risk factors for venous thromboembolism after carbon monoxide poisoning: A nationwide population-based study

Abstract

Introduction: The risk of venous thromboembolism increases after acute carbon monoxide poisoning. However, studies on the characteristics of patients who develop venous thromboembolism after carbon monoxide poisoning are rare. The aim of this study was to identify the risk factors for venous thromboembolism within 3 months after carbon monoxide poisoning. Methods: This is a population-based study that employed nationwide claims data from South Korea. Among the carbon monoxide poisoning patients (> 18 years), the characteristics of the groups with and without venous thromboembolism (pulmonary embolism or deep vein thrombosis) were identified. All the significant variables in the univariable analysis were included in the multivariable logistic regression to determine the risk factors for venous thromboembolism occurrence. Results: Among the 24,232 carbon monoxide poisoning patients, 130 subjects developed venous thromboembolism within 90 days of their carbon monoxide poisoning diagnosis. The significant risk factors for venous thromboembolism in the multivariable analysis were age (adjusted odds ratio (aOR) = 1.01; 95% confidence interval (CI) = 1.003-1.03), intensive care unit admission (aOR = 3.80; 95% CI = 2.34-6.12), length of stay (aOR = 1.02; 95% CI = 1.0001-1.04), congestive heart failure (aOR = 2.17; 95% CI = 1.36-3.42), and cancer (aOR = 1.94; 95% CI = 1.10-3.22). The adjusted odds ratios for intensive care unit admission for patients with pulmonary embolism and deep vein thrombosis were 3.05 (95% CI = 1.61-5.61) and 5.60 (95% CI = 2.89-10.90), respectively. Conclusion: Patients with older age, intensive care unit admission, a longer length of stay, congestive heart failure, or cancer are at greater risk of developing venous thromboembolism after carbon monoxide poisoning. In particular, intensive care unit admission was the strongest risk factor for venous thromboembolism, pulmonary embolism, and deep vein thrombosis. Monitoring and administering prophylactic treatments to prevent venous thromboembolism would be helpful in high-risk in carbon monoxide poisoning patients.