INTRODUCTION The affinity of hemoglobin for carbon monoxide (CO) is 250 times higher than that for oxygen. Therefore, exposure to CO leads to a reduction in oxygen delivery to tissues, resulting in cellular hypoxia and affects whole body. Hepatic dysfunction in critically ill patients is related to poor outcome, but few studies have been conducted on this subject that occurs after CO poisoning. This study aims to conduct a study of hepatic injury in CO-poisoned patients in emergency department (ED). METHODS This retrospective observational study collected data from patients who were diagnosed with acute CO poisoning at the ED between June 2011 and May 2018 in local tertiary-care hospital (Wonju, Republic of Korea). The primary end point of this study was to describe the prevalence of hepatic injury in acute CO-poisoned patients. The secondary goals were to investigate the recovery trends of hepatic injury caused by acute CO poisoning and the relation to neurologic outcome and mortality. RESULTS Eight hundred ninety-four patients were enrolled in the final analysis, 128 cases (14.3%) had subclinical hepatic injury and 15 (1.6%) cases had hepatic injury. The relationship with mortality was not statistically significant. However, the hepatic injury group was higher incidence of intensive care unit admission and other complications. Patients in the hepatic injury group recovered through conservative management within 1 week of being admitted to the ED. CONCLUSIONS While CO-induced hepatic injury is relatively uncommon, it can be associated with complications and poor neurologic outcome. However, CO-induced hepatic injury was not found to have a statistically significant effect on mortality rate.

中文翻译：

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急诊科急性一氧化碳中毒患者肝损伤评估[J].

引言 血红蛋白对一氧化碳 (CO) 的亲和力是对氧气的 250 倍。因此，暴露于一氧化碳会导致向组织输送的氧气减少，从而导致细胞缺氧并影响整个身体。危重患者的肝功能障碍与预后不良有关，但很少有关于 CO 中毒后发生的这一主题的研究。本研究旨在对急诊科 (ED) 一氧化碳中毒患者的肝损伤进行研究。方法 这项回顾性观察研究收集了 2011 年 6 月至 2018 年 5 月在当地三级医院（大韩民国原州）在急诊科被诊断为急性 CO 中毒的患者的数据。本研究的主要终点是描述急性一氧化碳中毒患者肝损伤的发生率。次要目标是调查急性一氧化碳中毒引起的肝损伤的恢复趋势以及与神经系统结局和死亡率的关系。结果最终纳入894例患者，其中亚临床肝损伤128例（14.3%），肝损伤15例（1.6%）。与死亡率的关系没有统计学意义。但肝损伤组入住重症监护室等并发症的发生率较高。肝损伤组患者在入住 ED 后 1 周内通过保守治疗恢复。结论 虽然 CO 引起的肝损伤相对少见，但它可能与并发症和不良的神经系统预后有关。然而，