Abstract | BACKGROUND & AIMS: METHODS: Patients hospitalized for acetaminophen overdose between 1995 and 2004 were identified retrospectively by using administrative data. Comorbid conditions, suicidal intent, and hepatotoxicity were identified by using International Classification of Diseases-Ninth Revision-Clinical Modification and International Statistical Classification of Diseases and Health-Related Problems, 10th revision diagnostic codes. RESULTS: During the 10-year interval, 1543 patients were hospitalized for acetaminophen overdose; 34% were alcohol abusers, 3% had liver disease, and 13% overdosed unintentionally. Seventy patients (4.5%) developed hepatotoxicity. Unintentional overdoses (odds ratio [OR], 5.18; 95% confidence interval [CI], 3.00-8.95), alcohol abuse (OR, 2.21; 95% CI, 1.30-3.76), underlying liver disease (OR, 3.50; 95% CI, 1.57-7.77), and N-acetylcysteine treatment (OR, 6.75; 95% CI, 2.78-16.39) were independently associated with hepatotoxicity. Fifteen patients (1.0%) died in-hospital; risk factors included older age, unintentional overdoses, alcohol abuse, comorbidities including liver disease, and hepatotoxicity (14% vs 0.3%; P < .0005). During a median follow-up of 5.2 years (range, 1 day-11.0 years), 79 patients (5.1%) died. Approximately half of these deaths were due to preventable conditions including suicide, substance abuse, and trauma. CONCLUSIONS: In this population-based study, acetaminophen overdose had a relatively benign short-term course but was associated with substantial long-term mortality caused by preventable conditions. Acetaminophen-related hepatotoxicity is more common in patients with unintentional overdoses, alcohol abuse, and underlying liver disease.
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Authors | Robert P Myers, Abdel Aziz M Shaheen, Bing Li, Stafford Dean, Hude Quan |
Journal | Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
(Clin Gastroenterol Hepatol)
Vol. 6
Issue 8
Pg. 918-25; quiz 837
(Aug 2008)
ISSN: 1542-7714 [Electronic] United States |
PMID | 18486561
(Publication Type: Journal Article)
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Chemical References |
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Topics |
- Acetaminophen
(toxicity)
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Alcoholism
(complications)
- Child
- Child, Preschool
- Drug Overdose
(mortality)
- Eating
- Female
- Hospitalization
- Humans
- Infant
- Infant, Newborn
- Liver Diseases
(complications)
- Male
- Middle Aged
- Retrospective Studies
- Risk Factors
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