The "smoker's paradox" suggests that smoking may protect the brain during acute carbon monoxide (CO) poisoning. Earlier studies have explored this idea.
To test the theory, researchers ran a retrospective study. They reviewed data from 1,150 patients with acute CO poisoning. The team compared neurocognitive outcomes in smokers and non-smokers. They aimed to reduce bias and control for confounding factors.
They used Propensity Score Matching (PSM) to adjust key variables such as age, Glasgow Coma Scale (GCS) score, co-morbidities, and HBO2 therapy. PSM allowed a fair comparison between the two groups.
Initial results showed better outcomes in smokers. Their risk of poor outcomes was 0.56 times lower. However, after PSM, this difference lost statistical strength. At one month, both groups showed similar outcomes.
Smokers still had a lower relative risk, but it was not significant. The findings did not support a protective effect of smoking. Smoking status did not predict better neurocognitive outcomes after adjusting for confounders.
These results suggest that other factors caused the early difference. The study highlights the need to control for confounding elements. It adds new insight into smoking's role in CO poisoning outcomes.. Link: https://pubmed.ncbi.nlm.nih.gov/40217947/