Zatrucie tlenkiem węgla
Rokowania, prognozy i postęp choroby

Rokowanie w zatruciu tlenkiem węgla (CO) zależy od wielu czynników klinicznych i laboratoryjnych. Kluczowymi predyktorami złego rokowania są: niska wartość w skali Glasgow (GCS ≤ 13, p=0,008), podwyższony poziom mocznika (BUN, p=0,002), czas intubacji powyżej 1,5 dnia (AUC 0,793-0,817), a także liczba zabiegów tlenoterapii hiperbarycznej. System oceny ABCG wskazuje na wiek (OR 1,04, p=0,003), obecność oparzeń (OR 3,99, p=0,006), GCS ≤ 13 (OR 4,62, p<0,001) oraz poziom CRP (OR 1,66, p=0,006) jako niezależne czynniki prognostyczne. Dodatkowo, istotne są współistniejące choroby przewlekłe, celowe zatrucie CO, niedokrwienie mięśnia sercowego, zatrzymanie krążenia, śpiączka, kwasica metaboliczna oraz wysokie poziomy karboksyhemoglobiny (HbCO). W populacji pediatrycznej ryzyko ciężkiego przebiegu zwiększają niski wynik GCS, leukocytoza oraz podwyższony poziom troponiny T przy przyjęciu.

Zatrucie tlenkiem węgla – prognoza (przewidywanie wyniku leczenia)

Rokowanie w przypadku zatrucia tlenkiem węgla (CO) zależy od wielu czynników, które mogą wpływać na wynik leczenia. Identyfikacja czynników prognostycznych ma kluczowe znaczenie dla wczesnej interwencji, optymalizacji strategii leczenia oraz poprawy wyników klinicznych pacjentów z zatruciem CO.12

Wskaźniki rokowania

Wśród najważniejszych czynników prognostycznych zatrucia tlenkiem węgla wyróżniono:34

  • Skala Glasgow (GCS) – niższy wynik GCS (szczególnie GCS ≤ 13) jest silnym predyktorem niekorzystnego rokowania (p=0,008)
  • Poziom mocznika (BUN) w surowicy – podwyższony poziom BUN wiąże się z gorszym rokowaniem (p=0,002)
  • Czas intubacji – punkt odcięcia wynoszący 1,5 dnia dla wszystkich pacjentów i 2,5 dnia dla pacjentów z intubacją (AUC = 0,793-0,817) jest istotnym wskaźnikiem złego rokowania
  • Liczba zabiegów tlenoterapia-hiperbaryczna/” title=”tlenoterapia hiperbaryczna” class=”to-tag” data-termid=”26391″>tlenoterapii hiperbarycznej – ma wpływ na wynik leczenia

34

Nowsze badania potwierdzają również znaczenie innych czynników. W ramach stworzonego systemu oceny ABCG (jako narzędzia prognostycznego) zidentyfikowano cztery niezależne predyktory niekorzystnych wyników:5

  • Wiek (współczynnik szans [OR] 1,04, 95% CI 1,01-1,07, P=0,003)
  • Obecność oparzeń (OR 3,99, 95% CI 1,51-11,11, P=0,006)
  • GCS ≤ 13 (OR 4,62, 95% CI 2,63-8,68, P<0,001)
  • Poziom białka C-reaktywnego (CRP) (OR 1,66, 95% CI 1,19-2,52, P=0,006)

56

Czynniki ryzyka niekorzystnego rokowania

Badania wykazały również inne istotne czynniki wpływające na rokowanie:78

  • Wiek pacjenta – starsi pacjenci mają gorsze rokowanie (p<0,001)
  • Choroby przewlekłe – współistniejące choroby mogą predysponować do gorszych wyników
  • Celowe zatrucie CO – wiąże się ze znacząco gorszymi wynikami leczenia w porównaniu z przypadkowym narażeniem
  • Niedokrwienie mięśnia sercowego – występuje u około jednej trzeciej pacjentów z umiarkowanym lub ciężkim zatruciem CO i wiąże się ze zwiększoną długoterminową śmiertelnością
  • Zatrzymanie krążenia, śpiączka, kwasica metaboliczna – są związane z gorszym rokowaniem
  • Wysokie poziomy karboksyhemoglobiny (HbCO) – wiążą się z gorszym rokowaniem

910

W przypadku populacji pediatrycznej, czynnikami ryzyka ciężkiego przebiegu są:11

11

Prognoza krótko- i długoterminowa

Śmiertelność związana z zatruciem CO wynosi około 1-3% w Stanach Zjednoczonych, przy czym śmiertelność jest wyższa w przypadku celowego zatrucia niż w przypadku przypadkowego narażenia. Szacuje się, że celowe zatrucie CO odpowiada za dwie trzecie zgonów.12 Jedno z badań wykazało, że około 30% osób z ciężkim zatruciem CO będzie miało śmiertelny przebieg.13

U pacjentów, którzy przeżyli początkowe zatrucie, chorbowotwórczość wiąże się głównie z późnymi zaburzeniami neurokognitywnymi, które utrzymują się u nawet 40% ofiar.14 Wśród osób z łagodnymi do umiarkowanych objawów, nawet jedna na pięć może rozwinąć trwałe problemy neurologiczne, natomiast wśród osób z ciężkimi objawami, nawet dwie na trzy mogą mieć długoterminowe powikłania, szczególnie neurologiczne.15

Długoterminowa obserwacja (mediana 7,6 lat) kohorty pacjentów z umiarkowanym do ciężkiego zatrucia CO, którzy doznali ostrego uszkodzenia mięśnia sercowego, wykazała wskaźnik śmiertelności na poziomie 24%. Śmiertelność wśród pacjentów z uszkodzeniem mięśnia sercowego była ponad dwukrotnie wyższa niż u zatrutych pacjentów bez oznak takiego uszkodzenia i oszacowano, że jest trzy razy wyższa niż oczekiwany wskaźnik dla porównywalnej niezatrutej kohorty.16

Powikłania długoterminowe

Długoterminowe powikłania neurologiczne po zatruciu CO obejmują:17

1718

U kobiet w ciąży zatrucie może spowodować śmierć płodu lub mózgowe porażenie dziecięce u dziecka.19

Badania wykazały również potencjalne długoterminowe konsekwencje zatrucia CO:20

  • Zwiększone ryzyko nowotworów – badanie z wykorzystaniem bazy danych National Health Insurance Service (NHIS) Korei wykazało związek między zatruciem CO a rozwojem nowotworów złośliwych narządów wewnętrznych (skorygowany współczynnik ryzyka [aHR] dla nowotworów złośliwych narządów litych wynosił 1,03). Szczególnie podwyższone było ryzyko nowotworów jamy ustnej (aHR 1,33), płuc (aHR 1,39), kości (aHR 1,68), szyjki macicy (aHR 1,32) i nerek (aHR 1,14).
  • Migreny – badanie wykorzystujące bazę danych NHIS Korei wskazało, że zatrucie CO jest powiązane z rozwojem migren (aHR 1,37).

2021

Osoby, które przeżyły celowe zatrucie CO, są obarczone bardzo wysokim ryzykiem późniejszego samobójstwa.22

Trendy i prognozy zapadalności

Analiza trendów z Chin wykazała zmniejszającą się tendencję w standaryzowanym względem wieku współczynniku umieralności (ASMR) i standaryzowanych względem wieku latach życia skorygowanych niepełnosprawnością (ASDR) w latach 2000-2021, przy czym wskaźniki mężczyzn były konsekwentnie wyższe niż kobiet.23

Spadek obciążenia chorobą jest prawdopodobnie spowodowany postępem technologii medycznej i ulepszonymi wysiłkami na rzecz zapobiegania chorobom zawodowym, ale nadal pozostaje on wyższy niż średnia globalna.24 Przewiduje się, że ASMR i ASDR będą spadać w ciągu najbliższych 10 lat.25

Czynniki poprawiające rokowanie

Dla poprawy rokowania w zatruciu CO istotne są następujące działania:2627

  • Wczesne wdrożenie tlenoterapii hiperbarycznej – jako skuteczna metoda leczenia zatrucia CO, może skutecznie zmniejszyć śmiertelność, zapobiec wystąpieniu opóźnionej neuropatii i poprawić rokowanie pacjentów
  • Zwiększenie dostępności komór hiperbarycznych we wszystkich regionach
  • Poprawa efektywności regulacji w małych i średnich przedsiębiorstwach
  • Wzmocnienie szkoleń z zakresu bezpieczeństwa CO, szczególnie dla młodych pracowników płci męskiej w branżach wysokiego ryzyka

2627

Ograniczenia prognostyczne

Należy zauważyć, że występują pewne ograniczenia w prognozowaniu wyników zatrucia CO:2829

  • Zmienność nasilenia klinicznego, wartości laboratoryjnych i wyników ogranicza dokładność prognostyczną
  • Nieprawidłowe wyniki tomografii komputerowej (CT) lub rezonansu magnetycznego (MRI) są związane z utrzymującymi się zaburzeniami neurologicznymi
  • Testy neuropsychiatryczne mogą mieć skuteczność prognostyczną w określaniu opóźnionych następstw
  • Nie wszystkie markery biologiczne mają wartość prognostyczną – np. badania wykazały, że poziom fosforanu w surowicy mierzony na oddziale ratunkowym nie przewidywał złych wyników neurokognitywnych 1 miesiąc po zatruciu CO

2830

Wyniki po zatruciu są często trudne do przewidzenia, szczególnie u osób, które mają objawy zatrzymania krążenia, śpiączki, kwasicy metabolicznej lub mają wysoki poziom karboksyhemoglobiny.31

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  1. 10.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Carbon monoxide poisoning – UpToDate
    https://www.uptodate.com/contents/carbon-monoxide-poisoning
    Carbon monoxide poisoning is estimated to occur in 50,000 people annually in the United States, and non-fire-related smoke inhalation is responsible for most cases. Analysis of aggregated national data from the United States supports an overall mortality of 1 to 3 percent, with a mortality rate that is higher for intentional poisoning than for inadvertent exposure. There are approximately 1000 to 1300 deaths from CO poisoning annually. Intentional CO poisoning accounts for two-thirds of deaths and inadvertent, non-fire related CO poisoning cause the rest. […] Myocardial ischemia is common among moderately to severe CO-poisoned patients and is associated with increased long-term mortality. A retrospective study of 230 patients with moderate or severe CO poisoning referred to a specialized center found evidence of myocardial ischemia (characteristic electrocardiographic changes or elevated serum cardiac biomarkers) in one-third of all cases.
  • #2 A scoring system with high predictive performance for poor outcomes in acute carbon monoxide poisoning | Scientific Reports
    https://www.nature.com/articles/s41598-025-98162-1
    Carbon monoxide (CO) poisoning causes significant mortality and hypoxic brain injury. […] A model for predicting outcomes early after hospital admission is crucial for guiding care and early rehabilitation. […] Predictors of poor outcomes included age, GCS13, burns and low C-reactive protein levels. […] The ABCG score accurately predicts poor outcomes in acute CO poisoning and supports early intervention and treatment planning. […] This study aimed to develop and validate a practical and reliable scoring model to predict poor outcomes in cases of acute CO poisoning, facilitating better early intervention and optimised treatment strategies. […] Multivariable logistic regression analysis identified age (odds ratio [OR] 1.04, 95% CI 1.01-1.07, P=0.003), presence of burns (OR 3.99, 95% CI 1.51-11.11, P=0.006), GCS13 (OR 4.62, 95% CI 2.63-8.68, P<0.001), and CRP level (OR 1.66, 95% CI 1.19-2.52, P=0.006) as independent predictors of poor outcomes.
  • #3 Prognostic factors of carbon monoxide poisoning in Taiwan: a retrospective observational study
    https://pmc.ncbi.nlm.nih.gov/articles/PMC6886984/
    To identify the risk factors related to the prognosis of carbon monoxide (CO)-poisoned patients in the hospital. […] The logistic regression analysis confirmed that the Glasgow Coma Scale (GCS) score (p=0.008) and blood urea nitrogen (BUN) (p=0.002) were related to poor outcomes. Furthermore, the receiver operating characteristic (ROC) curve showed that the cut-off point of intubation days was 1.5 days (area under the ROC curve [AUC]=0.793) for all patients and 2.5 days (AUC=0.817) for patients with intubation when predicting poor outcomes. […] We identified the factors that most strongly predict the prognosis of CO poisoning, including the GCS score, serum BUN and intubation days. Moreover, the number of hyperbaric oxygen treatments seems to have impact of the outcome. […] Patients with poor outcomes were older than those who did not have poor outcomes (p0.001).
  • #4 Prognostic factors of carbon monoxide poisoning in Taiwan: a retrospective observational study – PubMed
    https://pubmed.ncbi.nlm.nih.gov/31740467/
    Objectives: To identify the risk factors related to the prognosis of carbon monoxide (CO)-poisoned patients in the hospital. […] The logistic regression analysis confirmed that the Glasgow Coma Scale (GCS) score (p=0.008) and blood urea nitrogen (BUN) (p=0.002) were related to poor outcomes. […] We identified the factors that most strongly predict the prognosis of CO poisoning, including the GCS score, serum BUN and intubation days. Moreover, the number of hyperbaric oxygen treatments seems to have impact of the outcome.
  • #4 Prognostic factors of carbon monoxide poisoning in Taiwan: a retrospective observational study
    https://pmc.ncbi.nlm.nih.gov/articles/PMC6886984/
    Patients who had chronic diseases may tend to have poor outcomes. […] The mean score of the GCS was around 11. […] The intubation days were used as a predictor of the outcome of CO poisoning. The results show that the AUC was around 0.7570.817 in all patients and in intubated patients. […] Our data revealed that patients exposed to CO intentionally have a significantly worse treatment outcome than those by accident. […] The factors best at predicting outcomes were a high GCS score, high BUN and more intubation days.
  • #5 A scoring system with high predictive performance for poor outcomes in acute carbon monoxide poisoning | Scientific Reports
    https://www.nature.com/articles/s41598-025-98162-1
    Carbon monoxide (CO) poisoning causes significant mortality and hypoxic brain injury. […] A model for predicting outcomes early after hospital admission is crucial for guiding care and early rehabilitation. […] Predictors of poor outcomes included age, GCS13, burns and low C-reactive protein levels. […] The ABCG score accurately predicts poor outcomes in acute CO poisoning and supports early intervention and treatment planning. […] This study aimed to develop and validate a practical and reliable scoring model to predict poor outcomes in cases of acute CO poisoning, facilitating better early intervention and optimised treatment strategies. […] Multivariable logistic regression analysis identified age (odds ratio [OR] 1.04, 95% CI 1.01-1.07, P=0.003), presence of burns (OR 3.99, 95% CI 1.51-11.11, P=0.006), GCS13 (OR 4.62, 95% CI 2.63-8.68, P<0.001), and CRP level (OR 1.66, 95% CI 1.19-2.52, P=0.006) as independent predictors of poor outcomes.
  • #6 A scoring system with high predictive performance for poor outcomes in acute carbon monoxide poisoning | Scientific Reports
    https://www.nature.com/articles/s41598-025-98162-1
    The ABCG score facilitates rapid risk stratification in clinical settings, promoting early intervention for high-risk patients, optimising treatment strategies and potentially improving outcomes. […] This study developed a simple and accurate scoring model, called the ABCG score, to predict poor outcomes in patients with acute CO poisoning.
  • #7 Prognostic factors of carbon monoxide poisoning in Taiwan: a retrospective observational study
    https://pmc.ncbi.nlm.nih.gov/articles/PMC6886984/
    Patients who had chronic diseases may tend to have poor outcomes. […] The mean score of the GCS was around 11. […] The intubation days were used as a predictor of the outcome of CO poisoning. The results show that the AUC was around 0.7570.817 in all patients and in intubated patients. […] Our data revealed that patients exposed to CO intentionally have a significantly worse treatment outcome than those by accident. […] The factors best at predicting outcomes were a high GCS score, high BUN and more intubation days.
  • #8 Carbon monoxide poisoning – UpToDate
    https://www.uptodate.com/contents/carbon-monoxide-poisoning
    Carbon monoxide poisoning is estimated to occur in 50,000 people annually in the United States, and non-fire-related smoke inhalation is responsible for most cases. Analysis of aggregated national data from the United States supports an overall mortality of 1 to 3 percent, with a mortality rate that is higher for intentional poisoning than for inadvertent exposure. There are approximately 1000 to 1300 deaths from CO poisoning annually. Intentional CO poisoning accounts for two-thirds of deaths and inadvertent, non-fire related CO poisoning cause the rest. […] Myocardial ischemia is common among moderately to severe CO-poisoned patients and is associated with increased long-term mortality. A retrospective study of 230 patients with moderate or severe CO poisoning referred to a specialized center found evidence of myocardial ischemia (characteristic electrocardiographic changes or elevated serum cardiac biomarkers) in one-third of all cases.
  • #9 Carbon Monoxide Toxicity: Practice Essentials, Pathophysiology, Etiology
    https://emedicine.medscape.com/article/819987-overview
    Considerations regarding prognosis include the following: Variability of clinical severity, laboratory values, and outcome limits prognostic accuracy. Cardiac arrest, coma, metabolic acidosis, and high HbCO levels are associated with poor outcome. Abnormal computed tomography (CT) or magnetic resonance imaging (MRI) scan findings are associated with persistent neurologic impairment. Neuropsychiatric testing may have prognostic efficacy in determining delayed sequelae. […] A study by Ahn et al using the National Health Insurance Service (NHIS) of Korea database found evidence for an association between CO poisoning and the development of internal malignancies. According to the investigators, the adjusted hazard ratio (aHR) for solid organ malignancies was 1.03 in persons with CO poisoning. More specifically, the aHRs for malignancies of the oral cavity, lungs, bones, cervix, and kidneys were, respectively, 1.33, 1.39, 1.68, 1.32, and 1.14. On the other hand, the internal malignancy risk was lower for the thorax, anus, uterus, ovaries, and prostate, and for Hodgkin lymphoma, non-Hodgkin lymphoma, and multiple myeloma. The risk of hematologic malignancies was also lower, with the aHR being 0.71. The mean follow-up time for the persons who suffered CO poisoning was 2350.91 days.
  • #10 Carbon monoxide poisoning – Wikipedia
    https://en.wikipedia.org/wiki/Carbon_monoxide_poisoning
    Prognosis Risk of death: 131% […] Outcomes are often difficult to predict following poisoning, especially people who have symptoms of cardiac arrest, coma, metabolic acidosis, or have high carboxyhemoglobin levels. […] One study reported that approximately 30% of people with severe carbon monoxide poisoning will have a fatal outcome.
  • #11 Carbon Monoxide Toxicity: Practice Essentials, Pathophysiology, Etiology
    https://emedicine.medscape.com/article/819987-overview
    A study by Hwang et al that also used the NHIS of Korea database indicated that CO poisoning is linked to the development of migraine headaches. The aHR for migraine was 1.37, with the risk being greater regardless of age, sex, or HBO therapy use. Mean follow-up for persons with CO poisoning was 5.9 years. […] An analysis of 331 pediatric patients with CO poisoning seen at a single-site emergency department found risk factors associated with severe disease course were a low Glasgow Coma Scale score, high leukocyte count, and high troponin T levels at presentation. Patients with myocardial injury from CO poisoning are at higher risk for short-term mortality, and survivors are at increased risk for neurocognitive sequelae and future myocardial infarction. […] Survivors of intentional CO poisoning are at extreme risk for subsequent completion of suicide.
  • #12 Carbon monoxide poisoning – UpToDate
    https://www.uptodate.com/contents/carbon-monoxide-poisoning
    Carbon monoxide poisoning is estimated to occur in 50,000 people annually in the United States, and non-fire-related smoke inhalation is responsible for most cases. Analysis of aggregated national data from the United States supports an overall mortality of 1 to 3 percent, with a mortality rate that is higher for intentional poisoning than for inadvertent exposure. There are approximately 1000 to 1300 deaths from CO poisoning annually. Intentional CO poisoning accounts for two-thirds of deaths and inadvertent, non-fire related CO poisoning cause the rest. […] Myocardial ischemia is common among moderately to severe CO-poisoned patients and is associated with increased long-term mortality. A retrospective study of 230 patients with moderate or severe CO poisoning referred to a specialized center found evidence of myocardial ischemia (characteristic electrocardiographic changes or elevated serum cardiac biomarkers) in one-third of all cases.
  • #13 Carbon monoxide poisoning – Wikipedia
    https://en.wikipedia.org/wiki/Carbon_monoxide_poisoning
    Prognosis Risk of death: 131% […] Outcomes are often difficult to predict following poisoning, especially people who have symptoms of cardiac arrest, coma, metabolic acidosis, or have high carboxyhemoglobin levels. […] One study reported that approximately 30% of people with severe carbon monoxide poisoning will have a fatal outcome.
  • #14 Carbon monoxide poisoning – UpToDate
    https://www.uptodate.com/contents/carbon-monoxide-poisoning
    In patients who survive the initial poisoning, morbidity is primarily related to late neurocognitive impairment and persists in up to 40 percent of victims. Significant CO poisoning may be associated with an increased risk of developing a subsequent seizure disorder. Long-term mortality is increased if CO poisoning causes myocardial injury. Long-term follow-up (median 7.6 years) of a cohort of patients with moderate to severe CO poisoning who sustained acute myocardial injury noted a mortality rate of 24 percent. Mortality among patients with myocardial injury was more than twice that of poisoned patients without evidence of such injury and was estimated to be triple the expected rate for a comparable non-poisoned cohort.
  • #15 Carbon Monoxide Poisoning – Harvard Health
    https://www.health.harvard.edu/a_to_z/carbon-monoxide-poisoning-a-to-z
    The prognosis depends on the severity of carbon monoxide poisoning. Among people with severe symptoms, as many as two out of three people may have long-term complications, especially neurological problems. […] In people with mild to moderate symptoms, as many as one in five can develop lasting neurological problems. Neurological problems range from mild personality changes to severe intellectual impairment, blindness and deafness. […] In pregnant women, poisoning can cause fetal death or cerebral palsy in the child.
  • #16 Carbon monoxide poisoning – UpToDate
    https://www.uptodate.com/contents/carbon-monoxide-poisoning
    In patients who survive the initial poisoning, morbidity is primarily related to late neurocognitive impairment and persists in up to 40 percent of victims. Significant CO poisoning may be associated with an increased risk of developing a subsequent seizure disorder. Long-term mortality is increased if CO poisoning causes myocardial injury. Long-term follow-up (median 7.6 years) of a cohort of patients with moderate to severe CO poisoning who sustained acute myocardial injury noted a mortality rate of 24 percent. Mortality among patients with myocardial injury was more than twice that of poisoned patients without evidence of such injury and was estimated to be triple the expected rate for a comparable non-poisoned cohort.
  • #17 Carbon Monoxide Poisoning – Harvard Health
    https://www.health.harvard.edu/a_to_z/carbon-monoxide-poisoning-a-to-z
    The prognosis depends on the severity of carbon monoxide poisoning. Among people with severe symptoms, as many as two out of three people may have long-term complications, especially neurological problems. […] In people with mild to moderate symptoms, as many as one in five can develop lasting neurological problems. Neurological problems range from mild personality changes to severe intellectual impairment, blindness and deafness. […] In pregnant women, poisoning can cause fetal death or cerebral palsy in the child.
  • #18 Carbon monoxide poisoning – UpToDate
    https://www.uptodate.com/contents/carbon-monoxide-poisoning
    In patients who survive the initial poisoning, morbidity is primarily related to late neurocognitive impairment and persists in up to 40 percent of victims. Significant CO poisoning may be associated with an increased risk of developing a subsequent seizure disorder. Long-term mortality is increased if CO poisoning causes myocardial injury. Long-term follow-up (median 7.6 years) of a cohort of patients with moderate to severe CO poisoning who sustained acute myocardial injury noted a mortality rate of 24 percent. Mortality among patients with myocardial injury was more than twice that of poisoned patients without evidence of such injury and was estimated to be triple the expected rate for a comparable non-poisoned cohort.
  • #19 Carbon Monoxide Poisoning – Harvard Health
    https://www.health.harvard.edu/a_to_z/carbon-monoxide-poisoning-a-to-z
    The prognosis depends on the severity of carbon monoxide poisoning. Among people with severe symptoms, as many as two out of three people may have long-term complications, especially neurological problems. […] In people with mild to moderate symptoms, as many as one in five can develop lasting neurological problems. Neurological problems range from mild personality changes to severe intellectual impairment, blindness and deafness. […] In pregnant women, poisoning can cause fetal death or cerebral palsy in the child.
  • #20 Carbon Monoxide Toxicity: Practice Essentials, Pathophysiology, Etiology
    https://emedicine.medscape.com/article/819987-overview
    Considerations regarding prognosis include the following: Variability of clinical severity, laboratory values, and outcome limits prognostic accuracy. Cardiac arrest, coma, metabolic acidosis, and high HbCO levels are associated with poor outcome. Abnormal computed tomography (CT) or magnetic resonance imaging (MRI) scan findings are associated with persistent neurologic impairment. Neuropsychiatric testing may have prognostic efficacy in determining delayed sequelae. […] A study by Ahn et al using the National Health Insurance Service (NHIS) of Korea database found evidence for an association between CO poisoning and the development of internal malignancies. According to the investigators, the adjusted hazard ratio (aHR) for solid organ malignancies was 1.03 in persons with CO poisoning. More specifically, the aHRs for malignancies of the oral cavity, lungs, bones, cervix, and kidneys were, respectively, 1.33, 1.39, 1.68, 1.32, and 1.14. On the other hand, the internal malignancy risk was lower for the thorax, anus, uterus, ovaries, and prostate, and for Hodgkin lymphoma, non-Hodgkin lymphoma, and multiple myeloma. The risk of hematologic malignancies was also lower, with the aHR being 0.71. The mean follow-up time for the persons who suffered CO poisoning was 2350.91 days.
  • #21 Carbon Monoxide Toxicity: Practice Essentials, Pathophysiology, Etiology
    https://emedicine.medscape.com/article/819987-overview
    A study by Hwang et al that also used the NHIS of Korea database indicated that CO poisoning is linked to the development of migraine headaches. The aHR for migraine was 1.37, with the risk being greater regardless of age, sex, or HBO therapy use. Mean follow-up for persons with CO poisoning was 5.9 years. […] An analysis of 331 pediatric patients with CO poisoning seen at a single-site emergency department found risk factors associated with severe disease course were a low Glasgow Coma Scale score, high leukocyte count, and high troponin T levels at presentation. Patients with myocardial injury from CO poisoning are at higher risk for short-term mortality, and survivors are at increased risk for neurocognitive sequelae and future myocardial infarction. […] Survivors of intentional CO poisoning are at extreme risk for subsequent completion of suicide.
  • #22 Carbon Monoxide Toxicity: Practice Essentials, Pathophysiology, Etiology
    https://emedicine.medscape.com/article/819987-overview
    A study by Hwang et al that also used the NHIS of Korea database indicated that CO poisoning is linked to the development of migraine headaches. The aHR for migraine was 1.37, with the risk being greater regardless of age, sex, or HBO therapy use. Mean follow-up for persons with CO poisoning was 5.9 years. […] An analysis of 331 pediatric patients with CO poisoning seen at a single-site emergency department found risk factors associated with severe disease course were a low Glasgow Coma Scale score, high leukocyte count, and high troponin T levels at presentation. Patients with myocardial injury from CO poisoning are at higher risk for short-term mortality, and survivors are at increased risk for neurocognitive sequelae and future myocardial infarction. […] Survivors of intentional CO poisoning are at extreme risk for subsequent completion of suicide.
  • #23 Trend analysis and prediction of disease burden of occupational carbon monoxide poisoning in China based on the past two decades | Scientific Reports
    https://www.nature.com/articles/s41598-025-99887-9
    This study aims to analyse and predict the disease burden of occupational carbon monoxide (CO) poisoning in China and provide recommendations for its prevention and treatment. […] The results show a decreasing trend in age-standardised mortality rate (ASMR) and age-standardised disability-adjusted life years (ASDR) from 2000 to 2021, with male rates consistently higher than female rates. […] The decline in disease burden is likely to be due to advances in medical technology and improved efforts to prevent occupational diseases, but it remains higher than the global average and in several SDI regions. […] Further actions are needed to reduce the burden of occupational CO poisoning, including increasing the coverage of hyperbaric chambers in all regions, improving the efficiency of regulation of small and medium-sized enterprises, and strengthening CO safety training, especially for young male workers in high-risk industries.
  • #24 Trend analysis and prediction of disease burden of occupational carbon monoxide poisoning in China based on the past two decades | Scientific Reports
    https://www.nature.com/articles/s41598-025-99887-9
    This study aims to analyse and predict the disease burden of occupational carbon monoxide (CO) poisoning in China and provide recommendations for its prevention and treatment. […] The results show a decreasing trend in age-standardised mortality rate (ASMR) and age-standardised disability-adjusted life years (ASDR) from 2000 to 2021, with male rates consistently higher than female rates. […] The decline in disease burden is likely to be due to advances in medical technology and improved efforts to prevent occupational diseases, but it remains higher than the global average and in several SDI regions. […] Further actions are needed to reduce the burden of occupational CO poisoning, including increasing the coverage of hyperbaric chambers in all regions, improving the efficiency of regulation of small and medium-sized enterprises, and strengthening CO safety training, especially for young male workers in high-risk industries.
  • #25 Trend analysis and prediction of disease burden of occupational carbon monoxide poisoning in China based on the past two decades | Scientific Reports
    https://www.nature.com/articles/s41598-025-99887-9
    The results of this study show that the overall trend of ASMR and ASDR in China is decreasing during 2000-2021, indicating that China has made some achievements in occupational safety and health and in the treatment and prognosis of occupational diseases in the 21st century. […] Hyperbaric oxygen, as an effective treatment for CO poisoning, can effectively reduce the mortality rate of CO poisoning, prevent the occurrence of delayed-onset neuropathy in CO poisoning, and improve the prognosis of patients, thus reducing DALYs. […] The predicted results showed that the ASMR and ASDR were decreasing in the next 10 years. […] It shows that, since the beginning of the 21st century, with the continuous progress of medical care and the amendment of the Law of the Peoples Republic of China on Prevention and Control of Occupational Diseases, which was formulated according to the Constitution, not only strengthened the responsibility of enterprises, but also promoted the establishment of a monitoring system for occupational exposures, China gradually emphasized the development of occupational diseases, and made certain achievements in occupational disease prevention and control.
  • #26 Trend analysis and prediction of disease burden of occupational carbon monoxide poisoning in China based on the past two decades | Scientific Reports
    https://www.nature.com/articles/s41598-025-99887-9
    This study aims to analyse and predict the disease burden of occupational carbon monoxide (CO) poisoning in China and provide recommendations for its prevention and treatment. […] The results show a decreasing trend in age-standardised mortality rate (ASMR) and age-standardised disability-adjusted life years (ASDR) from 2000 to 2021, with male rates consistently higher than female rates. […] The decline in disease burden is likely to be due to advances in medical technology and improved efforts to prevent occupational diseases, but it remains higher than the global average and in several SDI regions. […] Further actions are needed to reduce the burden of occupational CO poisoning, including increasing the coverage of hyperbaric chambers in all regions, improving the efficiency of regulation of small and medium-sized enterprises, and strengthening CO safety training, especially for young male workers in high-risk industries.
  • #27 Trend analysis and prediction of disease burden of occupational carbon monoxide poisoning in China based on the past two decades | Scientific Reports
    https://www.nature.com/articles/s41598-025-99887-9
    The results of this study show that the overall trend of ASMR and ASDR in China is decreasing during 2000-2021, indicating that China has made some achievements in occupational safety and health and in the treatment and prognosis of occupational diseases in the 21st century. […] Hyperbaric oxygen, as an effective treatment for CO poisoning, can effectively reduce the mortality rate of CO poisoning, prevent the occurrence of delayed-onset neuropathy in CO poisoning, and improve the prognosis of patients, thus reducing DALYs. […] The predicted results showed that the ASMR and ASDR were decreasing in the next 10 years. […] It shows that, since the beginning of the 21st century, with the continuous progress of medical care and the amendment of the Law of the Peoples Republic of China on Prevention and Control of Occupational Diseases, which was formulated according to the Constitution, not only strengthened the responsibility of enterprises, but also promoted the establishment of a monitoring system for occupational exposures, China gradually emphasized the development of occupational diseases, and made certain achievements in occupational disease prevention and control.
  • #28 Carbon Monoxide Toxicity: Practice Essentials, Pathophysiology, Etiology
    https://emedicine.medscape.com/article/819987-overview
    Considerations regarding prognosis include the following: Variability of clinical severity, laboratory values, and outcome limits prognostic accuracy. Cardiac arrest, coma, metabolic acidosis, and high HbCO levels are associated with poor outcome. Abnormal computed tomography (CT) or magnetic resonance imaging (MRI) scan findings are associated with persistent neurologic impairment. Neuropsychiatric testing may have prognostic efficacy in determining delayed sequelae. […] A study by Ahn et al using the National Health Insurance Service (NHIS) of Korea database found evidence for an association between CO poisoning and the development of internal malignancies. According to the investigators, the adjusted hazard ratio (aHR) for solid organ malignancies was 1.03 in persons with CO poisoning. More specifically, the aHRs for malignancies of the oral cavity, lungs, bones, cervix, and kidneys were, respectively, 1.33, 1.39, 1.68, 1.32, and 1.14. On the other hand, the internal malignancy risk was lower for the thorax, anus, uterus, ovaries, and prostate, and for Hodgkin lymphoma, non-Hodgkin lymphoma, and multiple myeloma. The risk of hematologic malignancies was also lower, with the aHR being 0.71. The mean follow-up time for the persons who suffered CO poisoning was 2350.91 days.
  • #29 Carbon monoxide poisoning – Wikipedia
    https://en.wikipedia.org/wiki/Carbon_monoxide_poisoning
    Prognosis Risk of death: 131% […] Outcomes are often difficult to predict following poisoning, especially people who have symptoms of cardiac arrest, coma, metabolic acidosis, or have high carboxyhemoglobin levels. […] One study reported that approximately 30% of people with severe carbon monoxide poisoning will have a fatal outcome.
  • #30 :: Clinical and Experimental Emergency Medicine
    https://www.ceemjournal.org/m/journal/view.php?doi=10.15441/ceem.22.299
    Serum phosphate level measured in the ED did not predict poor neurocognitive outcomes 1 month after CO poisoning. […] Serum phosphate was not a significant predictor of poor prognosis. […] In addition, serum phosphate did not have statistically significant linear trend at 1 month after CO poisoning. […] This means that serum phosphate level alone cannot predict a poor outcome 1 month after acute CO poisoning.
  • #31 Carbon monoxide poisoning – Wikipedia
    https://en.wikipedia.org/wiki/Carbon_monoxide_poisoning
    Prognosis Risk of death: 131% […] Outcomes are often difficult to predict following poisoning, especially people who have symptoms of cardiac arrest, coma, metabolic acidosis, or have high carboxyhemoglobin levels. […] One study reported that approximately 30% of people with severe carbon monoxide poisoning will have a fatal outcome.