Evaluation of clinical findings of acetaminophen poisoning and factors associated with its severity in poisoned patients

Abstract

Introduction: Acetaminophen poisoning is one of the most common types of suicide in Iran. Investigation and identification of factors affecting the severity of this poisoning can have a significant impact on optimal treatment management. The aim of this study was to evaluate the clinical findings of Acetaminophen poisoning and its associated factors.

Materials and Methods: In a cross-sectional study, the files of patients admitted due to acetaminophen poisoning in the years 2011-2015 in the poisoning ward of Razi Educational Center in Rasht have been reviewed. Demographic characteristics of the poisoned, acetaminophen use, number of days of hospitalization, poisoning outcome, history of addiction, previous suicide history, time spent from drug use to hospitalization, clinical findings, severity of poisoning and laboratory test results were extracted from patients' records and registration. Independent t-test, chi-square and regression analysis were used to investigate the relationship between study variables and severity of intoxication.

Results: In this study, 244 cases of poisoning were investigated. The highest frequency of symptoms was related to nausea (25.9%) and then vomiting (22.1%). More than 99% of those poisoned recovered. Mean hospital stay (P = 0.015), mean hospital stay after acetaminophen (P = 0.001) and mean liver enzyme levels (P < 0.05) were significantly higher in the moderate to severe intoxication group compared to the asymptomatic group. In the logistic regression analysis, even after removing confounders, there was a statistically significant association between the duration of the patient's arrival at the hospital (P <0.001, OR = 15.44; 95% CI: 5.88- 40.44) and the amount of acetaminophen consumption (P <0.001, OR = 4.62; 95% CI: 2.00- 10.68) with severe poisoning.

Conclusion: In this study, most of those poisoned were female and aged 21-30 years. Most of the poisoned recovered. The acetaminophen dose and the duration of drug intake until hospitalization were significantly associated with the severity of poisoning and the mean values of liver function tests were higher in the high poisoning group.