Gut. 2005 May;54(5):686-90. Related Articles, Links


Age and paracetamol self-poisoning.

Schmidt LE.

Department of Hepatology A. 2.12.1, Rigshospitalet, Blegdamsvej 9, DK-2100
Copenhagen O, Denmark. lars.schmidt@...

BACKGROUND: Whereas paracetamol poisoning is predominantly seen in
adolescents and young adults, the majority of paracetamol associated deaths
occur in an older population. AIMS: The aim of the present study was to
evaluate age as a risk factor for fulminant hepatic failure (FHF) and death
in a large population of patients with paracetamol poisoning. PATIENTS: A
total of 746 patients transferred to a specialised unit with severe
paracetamol poisoning and 273 unselected patients admitted from the local
region over a 10 year period. METHODS: A partly retrospective study based on
hospital charts. The risk associated with age was evaluated by multivariate
analysis. RESULTS: Paracetamol poisoning most frequently occurred in the age
group 15-24 years. Transferred patients were significantly older than local
patients (median age 37 years v 29 years; p = 0.0006). In contrast, FHF and
death from paracetamol poisoning most frequently occurred in patients aged
40 years or above. In a logistic regression analysis, "age >/=40 years" was
associated with an excess risk of FHF (odds ratio (OR) 2.33 (95% confidence
interval (CI) 1.50-3.64)) and death or liver transplantation (OR 4.18 (95%
CI 2.17-8.05)). In addition, older age was associated with other risk
factors for paracetamol hepatotoxicity such as regular alcohol abuse and
late presentation. CONCLUSIONS: Age 40 years or above was identified as a
significant independent risk factor for FHF and mortality following
paracetamol overdose. Patients aged 40 years or above should be considered
as high risk patients, in particular when older age appears in combination
with regular alcohol abuse or late presentation.

PMID: 15831917