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Risk Factors for Hepatotoxicity Due to Paracetamol Overdose in Adults

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 he...

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Autores principales: Popiolek, Iwona, Hydzik, Piotr, Jagielski, Pawel, Zrodlowska, Monika, Mystek, Karol, Porebski, Grzegorz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8402128/
https://www.ncbi.nlm.nih.gov/pubmed/34440958
http://dx.doi.org/10.3390/medicina57080752
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author Popiolek, Iwona
Hydzik, Piotr
Jagielski, Pawel
Zrodlowska, Monika
Mystek, Karol
Porebski, Grzegorz
author_facet Popiolek, Iwona
Hydzik, Piotr
Jagielski, Pawel
Zrodlowska, Monika
Mystek, Karol
Porebski, Grzegorz
author_sort Popiolek, Iwona
collection PubMed
description 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.
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spelling pubmed-84021282021-08-29 Risk Factors for Hepatotoxicity Due to Paracetamol Overdose in Adults Popiolek, Iwona Hydzik, Piotr Jagielski, Pawel Zrodlowska, Monika Mystek, Karol Porebski, Grzegorz Medicina (Kaunas) Article 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. MDPI 2021-07-25 /pmc/articles/PMC8402128/ /pubmed/34440958 http://dx.doi.org/10.3390/medicina57080752 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Popiolek, Iwona
Hydzik, Piotr
Jagielski, Pawel
Zrodlowska, Monika
Mystek, Karol
Porebski, Grzegorz
Risk Factors for Hepatotoxicity Due to Paracetamol Overdose in Adults
title Risk Factors for Hepatotoxicity Due to Paracetamol Overdose in Adults
title_full Risk Factors for Hepatotoxicity Due to Paracetamol Overdose in Adults
title_fullStr Risk Factors for Hepatotoxicity Due to Paracetamol Overdose in Adults
title_full_unstemmed Risk Factors for Hepatotoxicity Due to Paracetamol Overdose in Adults
title_short Risk Factors for Hepatotoxicity Due to Paracetamol Overdose in Adults
title_sort risk factors for hepatotoxicity due to paracetamol overdose in adults
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8402128/
https://www.ncbi.nlm.nih.gov/pubmed/34440958
http://dx.doi.org/10.3390/medicina57080752
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