Analysis of the Australia and New Zealand referral criteria for transfer to a liver unit for paracetamol overdose.
acetaminophen
hepatic failure
prognostication
toxicity
Journal
Emergency medicine Australasia : EMA
ISSN: 1742-6723
Titre abrégé: Emerg Med Australas
Pays: Australia
ID NLM: 101199824
Informations de publication
Date de publication:
12 2021
12 2021
Historique:
revised:
11
03
2021
received:
31
08
2020
accepted:
17
04
2021
pubmed:
5
5
2021
medline:
26
11
2021
entrez:
4
5
2021
Statut:
ppublish
Résumé
Paracetamol overdose is common and can lead to fulminant hepatic failure. In cases that are not improving with standard medical therapy with N-acetylcysteine, some patients may require liver transplant. The Australia and New Zealand (ANZ) referral criteria for transfer to a liver unit have not been extensively studied for its predictive value. The aim of this study was to evaluate the ANZ referral criteria for predicting mortality in paracetamol overdose. This study involves a retrospective analysis of patients who developed hepatotoxicity post-paracetamol overdose presenting to an Australian health service with a liver transplant unit between 2010 and 2019 and were treated with N-acetylcysteine. The primary outcome was death or transplant. Out of 983 paracetamol overdose presentations, 81 (8.2%) cases developed hepatotoxicity. Of these, 17 cases (21%) met the composite endpoint of death or transplant. The ANZ referral criteria is highly sensitive at predicting the primary endpoint of death or transplant at time of referral 100% (95% confidence interval 81-100) but had low specificity at 30% (95% confidence interval 19-42). The ANZ referral criteria were highly sensitive for predicting the outcome of mortality and transplant. This is important for screening patients who may become unstable and difficult to transfer at a later stage of their admission.
Identifiants
pubmed: 33946130
doi: 10.1111/1742-6723.13795
doi:
Substances chimiques
Analgesics, Non-Narcotic
0
Acetaminophen
362O9ITL9D
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1021-1026Informations de copyright
© 2021 Australasian College for Emergency Medicine.
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