Paracetamol intoxications: a retrospective population-based study in Iceland.

To access publisher full text version of this article. Please click on the hyperlink in Additional Links field. Paracetamol is the most common cause of acute liver failure (ALF) in many countries. Much data on paracetamol toxicity originate from liver transplant centers and tertiary referral institu...

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Bibliographic Details
Published in:Scandinavian Journal of Gastroenterology
Main Authors: Kjartansdottir, Ingibjörg, Bergmann, Ottar M, Arnadottir, Ragna S, Björnsson, Einar S
Other Authors: Faculty of Public Health, University of Iceland, Reykjavik, Iceland.
Format: Article in Journal/Newspaper
Language:English
Published: 2013
Subjects:
Acetaminophen
Acute Disease
Adolescent
Adult
Age Factors
Aged
Analgesics
Non-Narcotic
Chi-Square Distribution
Drug Overdose
Drug-Induced Liver Injury
Female
Hospitalization
Humans
Iceland
Incidence
Male
Mental Disorders
Middle Aged
Retrospective Studies
Sex Factors
Suicide
Attempted
Transaminases
Young Adult
Alf
Online Access:http://hdl.handle.net/2336/300225
https://doi.org/10.3109/00365521.2012.703236
Description
Summary:To access publisher full text version of this article. Please click on the hyperlink in Additional Links field. Paracetamol is the most common cause of acute liver failure (ALF) in many countries. Much data on paracetamol toxicity originate from liver transplant centers and tertiary referral institutions. The authors analyzed the population-based annual incidence of paracetamol overdoses and ALF, and described the risk factors for hepatotoxicity. A search was undertaken for the diagnosis of paracetamol overdoses in the diagnoses registry of the National University Hospital of Iceland from 2004 to 2009 serving a population of 219,249 inhabitants. Relevant information was collected from medical records. A total of 1913 drug-related poisoning episodes were identified and reviewed, 352 (18%) involved paracetamol overdoses. The annual incidence of paracetamol overdoses declined from 30.0 (2004) to 16.0/100,000 per year (2009) (p < 0.05). The female/male ratio was 3.0 and the largest age group was 16-25 years. After the initial examination, 26% were discharged home. Hospitalized index visits were 182 with accidental overdoses constituting 16 (9%) with no gender difference. Compared with intentional overdose the accidental group had higher aminotransferases (p < 0.005). ALF occurred in 3.8% (7/182) of the index visits and the incidence was 0.7/100,000 per year. In the intentional group, 1.2% (2/163) developed ALF versus 25% (4/16) of the accidental group (p = 0.001). Only one patient died from ALF and none underwent liver transplantation. The annual incidence of paracetamol overdoses was high in this population-based study but declined. Young females with intentional overdose accounted for most of the cases, whereas accidental overdoses were more common in older patients. The occurrence of ALF was low and mostly associated with accidental overdose. National University Hospital of Iceland Research Fund

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