Risk Factors for Hepatotoxicity Due to Paracetamol Overdose in Adults

Medicina

Grzegorz Porebski¹  Pawel Jagielski²  Monika Zrodlowska³  Karol Mystek³  Iwona Popiolek⁴  Piotr Hydzik⁴ 

[1]Department of Clinical and Environmental Allergology, Jagiellonian University Medical College, Botaniczna 3, 31-503 Krakow, Poland

[2]Department of Nutrition and Drug Research, Faculty of Health Science, Jagiellonian University Medical College, Skawińska 8, 31-066 Krakow, Poland

[3]Faculty of Medicine, Jagiellonian University Medical College, sw. Anny 12, 31-008 Krakow, Poland

[4]Toxicology Clinical Department, University Hospital in Krakow, Jakubowskiego 2, 30-688 Krakow, Poland

关键词: paracetamol;    acetaminophen;    drug overdose;    hepatotoxicity;    liver injury;    risk factor;   

DOI  :  10.3390/medicina57080752

来源: DOAJ

【 摘 要 】

Background and Objectives: Over-the-counter availability and a good safety profile make paracetamol one of the most common analgesics in developed countries but also the leading cause of liver failure due to overdose. The objectives of the study were to identify modifiable risk factors for severe hepatotoxicity following paracetamol overdose in adults. Materials and Methods: A retrospective cohort study involved the consecutive adult patients hospitalized in a toxicological center over a period of seven years due to paracetamol overdose. Complete medical datasets of laboratory and anamnestic variables were analyzed and validated by means of logistic regression model. Results: A total of 185 patients entered the study, including 25 individuals who developed severe hepatotoxicity (plasma aminotransferases levels above 1000 UI/L) and 31 individuals with mild to moderate liver injury (plasma aminotransferases levels above upper normal range, but below 1000 UI/L). In the univariable analysis, significant hepatotoxicity risk factors were male gender, alcohol abuse, an ingested paracetamol dose, and a timespan from ingestion to hospital admission. The later one was the only significant risk factor in the multivariable model (adjusted odds ratio 1.08; 95% CI: 1.03–1.12). Conclusions: A delay in hospital admission, resulting in a delayed administration of disease-specific treatment outweighs any other known risk factors of paracetamol-induced hepatotoxicity.

【 授权许可】

Unknown