Acute and Critical Care

Original Articles

Epidemiology
Long-term mortality of adult patients with carbon monoxide poisoning presenting to the emergency department in Korea: a population-based cohort study: Sang Hwan Lee, Soo Rack Ryu, Kyung Hun Yoo, Juncheol Lee, Yongil Cho, Tae Ho Lim, Hyunggoo Kang, Jaehoon Oh, Byuk Sung Ko; Acute Crit Care. 2024;39(4):526-534. Published online November 18, 2024; DOI: https://doi.org/10.4266/acc.2024.00199

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Background
Carbon monoxide (CO) poisoning can lead to significant morbidity and mortality. However, relatively few studies have investigated its long-term mortality impact. This nationwide population-based cohort study examined the association between CO poisoning and long-term mortality.
Methods
This retrospective study utilized data from the National Health Insurance Service database in South Korea. We compared the patients with CO poisoning to those without CO poisoning. Inverse probability treatment weights were applied to both groups to control for potential confounding factors. Subsequently, mortality was assessed using the incidence rate and Cox proportional hazard ratios.
Results
This study included 23,387 patients with CO poisoning and 359,851 without it. Over a median follow-up period of 7.6 years after CO poisoning diagnosis, the mortality risk was 2.6 times higher in patients with CO poisoning compared to that in the control group. In a long-term follow-up of patients surviving beyond 30 days, mortality remained 2.18 times higher. Additionally, a higher mortality risk was observed in the relatively younger age group (18–39 years) and the group with fewer underlying diseases, as indicated by a Charlson Comorbidity Index score of 0.
Conclusions
CO poisoning is associated with an elevated long-term mortality rate particularly in a relatively young and healthy population.

Citations

Citations to this article as recorded by

Optimizing hyperbaric oxygen initiation time in carbon monoxide poisoning: a 3-hour window enhances neurological recovery via lactate clearance
Dongjun Xu, Xiaoqin Xu, Hui Sun, Jun Xu, Danting Fei, Yaye Shen
Open Medicine.2026;[Epub] CrossRef

Epidemiology
Red blood cell transfusion for critically ill patients admitted through the emergency department in South Korea: Tae Sung Kim, Yongil Cho, Hyuk Joong Choi, Joonbum Park, Wonhee Kim, Chiwon Ahn, Joon Young Kim; Acute Crit Care. 2024;39(4):517-525. Published online November 5, 2024; DOI: https://doi.org/10.4266/acc.2024.00577

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Abstract PDF

Background
Red blood cells (RBCs) are a limited resource, and the adverse effects of transfusion must be considered. Multiple randomized controlled trials on transfusion thresholds have been conducted, leading to the establishment of a restrictive transfusion strategy. This study aimed to investigate the status of RBC transfusions in critically ill patients.
Methods
This cohort study was conducted at five university hospitals in South Korea. From December 18, 2022, to November 30, 2023, 307 nontraumatic, anemic patients admitted to intensive care units through the emergency departments were enrolled. We determined whether patients received RBC transfusion, transfusion triggers, and the clinical results.
Results
Of the 154 patients who received RBC transfusions, 71 (46.1%) had a hemoglobin level of 7 or higher. Triggers other than hemoglobin level included increased lactate levels in 75 patients (48.7%), tachycardia in 47 patients (30.5%), and hypotension in 46 patients (29.9%). The 28-day mortality rate was not significantly reduced in the group that received transfusions compared to the non-transfusion group (21.4% vs. 26.8%, P=0.288). There was no difference in the intensive care unit and hospital length of stay or the proportion of survival to discharge between the two groups. The prognosis showed the same pattern in various subgroups.
Conclusions
Despite the large number of RBC transfusions used in contradiction to the restrictive strategy, there was no notable difference in the prognosis of critically ill patients. To minimize unnecessary RBC transfusions, the promotion of transfusion guidelines and research on transfusion criteria that reflect individual patient conditions are required.

Citations

Citations to this article as recorded by

Red Blood Cell Transfusion Beyond Restrictive Thresholds in Patients With Septic Shock and an Elevated Lactate Level: A Multicenter Observational Study
Kyung Hun Yoo, Gil Joon Suh, Woon Yong Kwon, Sung-Hyuk Choi, Sung Phil Chung, Won Young Kim, Kyuseok Kim, Yoo Seok Park, Tae Gun Shin, Byuk Sung Ko, Tae Ho Lim, Yongil Cho
Journal of Korean Medical Science.2026;[Epub] CrossRef

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