Long-term mortality of acetaminophen poisoning: a nationwide population-based cohort study with 10-year follow-up in Taiwan

Huang, Hsin-Yi; Ho, Chung‐Han; Weng, Shih‐Feng; Hsu, Chien‐Chin; Wang, Jhi-Joung; Su, Shih‐Bin; Lin, Hung‐Jung; Huang, Chien‐Cheng

doi:10.1186/s13049-017-0468-8

Cited by 10 publications

(6 citation statements)

References 21 publications

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“…Fifth, because we identified intoxication events based on ICD9 codes and the antidotes administered, there may have been some misclassification. However, previous studies based on similar databases showed reliable results [2,12,[47][48][49][50][51]. Our current research thus provides an overview of intoxication events in Taiwan between 2006 and 2013.…”

Section: Strengths and Limitationssupporting

confidence: 50%

Incidence of intoxication events and patient outcomes in Taiwan: A nationwide population-based observational study

Chen

Chan

2020

PLoS ONE

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Background Intoxicated patients were frequently managed in the emergency departments (ED) with few studies at national level. The study aimed to reveal the incidence, outcomes of intoxications and trend in Taiwan. Methods Adults admitted to an ED due to an intoxication event between 2006 and 2013 were identified using the Taiwan National Health Insurance Research Database. The rate of intoxication and severe intoxication events, mortality rate, hospital length of stay (LOS), and daily medical costs of these patients were analyzed. Changes over time were analyzed using Joinpoint models. Multivariable generalized regressions with GEE were used to assess the effect of sex, age, and presence of prior psychiatric illness. Results A total of 20,371 ED admissions due to intoxication events were identified during the study period, and the incidence decreased with annual percentage change of 4.7% from 2006 to 2013. The mortality rate, hospital LOS, and daily medical costs were not decreased over time. Males and geriatric patients had more severe intoxication events, greater mortality rates, and greater daily medical costs. Patients with psychiatric illnesses had higher mortality rates and a longer hospital LOS, but lower daily medical expenses. Conclusion From 2006 to 2013, there was a decline in the incidence of ED admission for intoxication events in Taiwan. Males, geriatric patients, and those with psychiatric illnesses had greater risks for severe intoxication and mortality.

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Section: Strengths and Limitationssupporting

confidence: 50%

Incidence of intoxication events and patient outcomes in Taiwan: A nationwide population-based observational study

Chen

Chan

2020

PLoS ONE

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“…ältesten Alters-gruppe. Dies steht im Einklang mit Huang et al, die einen Anstieg der Paracetamolvergiftungen im jüngeren Drittel ihrer Kohorte feststellten [7]. Die internationalen Unterschiede bei Substanzen, die zu akuten Vergiftungen führen, sind auffallend variierend, insbesondere wenn man den asiatischen und den europäischen Kontinent vergleicht: So gehört Kohlenmonoxid (CO) in einer Studie aus Hongkong zu den 4 häufigsten Substanzen, während in unserer Studie nur bei 11 Patienten (1,1 %) eine Vergiftung durch CO festgestellt wurde [10].…”

Section: Diskussionunclassified

Intensivmedizinische Versorgung von Patienten mit akuter Intoxikation in Deutschland – ein Rückblick über 20 Jahre

Bremen

Wirtz

Brozat

et al. 2022

Med Klin Intensivmed Notfmed

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Zusammenfassung Hintergrund Die vorliegende Studie präsentiert ein Kollektiv akut intoxikierter Patienten, die in den letzten 2 Jahrzehnten auf eine medizinische Intensivstation eines tertiären Versorgungszentrums in Deutschland aufgenommen wurden. Ziel der Arbeit Das Ziel der Studie bestand darin, einen Überblick zur akuten Intoxikation als relevantes intensivmedizinisches Krankheitsbild und hiermit assoziierte klinische Charakteristika sowie die Prognose der betroffenen Patienten zu bieten. Material und Methoden Die Studienkohorte umfasst 1030 Patienten, die in den Jahren1999–2019 aufgrund einer akuten Vergiftung auf die medizinische Intensivstation der Uniklinik RWTH Aachen aufgenommen wurden. Demographische und klinische Merkmale sowie das klinische Management wurden detailliert analysiert und zwischen alters- und geschlechtsspezifischen Untergruppen verglichen. Ergebnisse Suizidversuche stellten die häufigste Ursache für die intensivmedizinische Aufnahme intoxikierter Patienten dar. Insbesondere führten Medikamente, v. a. Antidepressiva, zu einer akuten Vergiftung. Die Substanzen variierten hierbei je nach Geschlecht und Alter der betroffenen Patienten. In der Subgruppe der älteren Patienten stellten Benzodiazepine die am häufigsten verwendeten Substanzen dar. 286 Patienten (28 %) entwickelten ≥ 1 Organversagen. Die Gesamtmortalität betrug 2,6 %. Im Vergleich der ersten (1999–2009) mit der zweiten Dekade (2010–2019) des Beobachtungszeitraums zeigte sich ein Trend zu einer häufigeren Einnahme von Antidepressiva und Alkohol, während die Verwendung von Benzodiazepinen rückläufig war. Diskussion Obwohl die Gesamtmortalität im beobachteten Kollektiv gering ist, repräsentieren akut vergiftete Patienten fast 10 % aller Einweisungen auf die Intensivstation und beanspruchen insbesondere in Zeiten begrenzter Intensivkapazitäten wertvolle Ressourcen.

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“…In chronic conditions such as cancer pain and osteoarthritis, patients required long-term high dose use of APAP [2], at the same time, increasing the risk of APAP poisoning. Clinical studies indicated that high dose use of APAP for controlling chronic pain caused toxic effects in many organs as well as increased long-term mortality [3,4]. The major APAP metabolism organ is liver.…”

Section: Introductionmentioning

confidence: 99%

Hepatoprotective Activity of Nelumbo nucifera Gaertn. Seedpod Extract Attenuated Acetaminophen-Induced Hepatotoxicity

et al. 2022

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The aim is to investigate the effect of lotus (Nelumbo nucifera Gaertn.) seedpod extract (LSE) on acetaminophen (APAP)-induced hepatotoxicity. LSE is rich in polyphenols and has potent antioxidant capacity. APAP is a commonly used analgesic, while APAP overdose is the main reason for drug toxicity in the liver. Until now, there has been no in vitro test of LSE in drug-induced hepatotoxicity responses. LSEs were used to evaluate the effect on APAP-induced cytotoxicity, ROS level, apoptotic rate, and molecule mechanisms. The co-treatment of APAP and LSEs elevated the survival rate and decreased intracellular ROS levels on HepG2 cells. LSEs treatment could significantly reduce APAP-induced HepG2 apoptosis assessed by DAPI and Annexin V/PI. The further molecule mechanisms indicated that LSEs decreased Fas/FasL binding and reduced Bax and tBid to restore mitochondrial structure and subsequently suppress downstream apoptosis cascade activation. These declines in COX-2, NF-κB, and iNOS levels were observed in co-treatment APAP and LSEs, which indicated that LSEs could ameliorate APAP-induced inflammation. LSE protected APAP-induced apoptosis by preventing extrinsic, intrinsic, and JNK-mediated pathways. In addition, the restoration of mitochondria and inflammatory suppression in LSEs treatments indicated that LSEs could decrease oxidative stress induced by toxic APAP. Therefore, LSE could be a novel therapeutic option for an antidote against overdose of APAP.

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Long-term mortality of acetaminophen poisoning: a nationwide population-based cohort study with 10-year follow-up in Taiwan

Cited by 10 publications

References 21 publications

Incidence of intoxication events and patient outcomes in Taiwan: A nationwide population-based observational study

Incidence of intoxication events and patient outcomes in Taiwan: A nationwide population-based observational study

Intensivmedizinische Versorgung von Patienten mit akuter Intoxikation in Deutschland – ein Rückblick über 20 Jahre

Hepatoprotective Activity of Nelumbo nucifera Gaertn. Seedpod Extract Attenuated Acetaminophen-Induced Hepatotoxicity

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