Risk Factors for Hepatotoxicity Due to Paracetamol Overdose in Adults

<i>Background and Objectives</i>: 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 fa...

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Bibliographic Details
Main Authors: Iwona Popiolek, Piotr Hydzik, Pawel Jagielski, Monika Zrodlowska, Karol Mystek, Grzegorz Porebski
Format: Article
Language:English
Published: MDPI AG 2021-07-01
Series:Medicina
Subjects:
Online Access:https://www.mdpi.com/1648-9144/57/8/752
Description
Summary:<i>Background and Objectives</i>: 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. <i>Materials and Methods</i>: 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. <i>Results</i>: 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). <i>Conclusions</i>: A delay in hospital admission, resulting in a delayed administration of disease-specific treatment outweighs any other known risk factors of paracetamol-induced hepatotoxicity.
ISSN:1010-660X
1648-9144