SynthesisJournal of Korean medical science2025
Fatality Rate in Hospitalized Patients Due to Carbon Monoxide Poisoning in the Democratic People's Republic of Korea.
Synthesis in Journal of Korean medical science, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe widespread use of polluting fuels for indoor heating in the Demographic People's Republic of Korea (DPRK, North Korea) poses a significant risk for unintentional carbon monoxide (CO) poisoning. Despite its public health impact, reliable national-level data on the burden of CO poisoning in the DPRK remain scarce. This study addresses the need for more accurate estimates by analyzing fatality rates among hospitalized patients.
methodsA meta-analysis was conducted to estimate the fatality rate of hospitalized patients with unintentional CO poisoning in the DPRK and to compare it with historical data from the Republic of Korea (ROK, South Korea). In the DPRK, relevant publications were identified through a keyword search of the North Korean Materials Center, and studies reporting both hospital admissions and fatality outcomes were selected for analysis. In the ROK, seven hospital-based studies conducted between the 1960s and 1970s were analyzed and stratified by the use of hyperbaric oxygen therapy (HBOT).
resultsThe fatality rate in hospitalized patients with unintentional CO poisoning in the DPRK was estimated at 6.49% (95% confidence interval [CI], 4.23-9.83%) using a random-effects model. This rate was 2.48 times higher (95% CI, 1.16-5.29) than that observed among ROK patients who received HBOT (2.62%; 95% CI, 1.38-4.91%). When compared to ROK patients who did not receive HBOT (6.26%; 95% CI, 4.10-9.42%), the DPRK fatality rate was 1.04 times higher (95% CI, 0.57-1.88), indicating comparable clinical outcomes in settings where advanced therapeutic interventions such as HBOT were not available.
conclusionAccurate estimation of fatality rates among hospitalized patients with CO poisoning is essential to understanding its disease burden in the DPRK. The continued use of low-quality solid fuels for residential heating contributes substantially to the risk of unintentional CO poisoning. These findings highlight the urgent need for evidence-based public health interventions and international collaboration to improve heating practices and reduce preventable morbidity and mortality.
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