CHU-LIN TSAIWEI-TIEN CHANGTE-I WENGCHENG-CHUNG FANGWEN-JONE CHEN2020-03-232020-03-2320040929-6646https://scholars.lib.ntu.edu.tw/handle/123456789/478140Background and Purpose: There is a paucity of information about acetaminophen intoxication from Taiwan. This study investigated the outcome and risk factors for acetaminophen-induced hepatotoxicity and validated the Rumack-Matthew nomogram in Taiwanese patients with acute acetaminophen intoxication. Methods: A total of 75 patients with acetaminophen intoxication admitted through the emergency department were included in this retrospective analysis. Patients with a serum acetaminophen concentration above the possible risk line on the nomogram were treatedArith oral N-acetylcysteine. The primary outcome measure was the development of major hcpatotoxicity, which was defined as a serum aminotransferase concentration greater than 1000 IU/L. Patient outcomes in the possible risk group and probable risk group were plotted on the modified Rumack-Matthew nomogram for validation. The risk factors for ace taminophen-induced hepatotoxicity were identified by multiple logistic regression analysis. Results: No hepatotoxicity developed in patients with an initial acetaminophen concentration below the possible risk line on the nomogran). One out of 8 patients in the possible risk group developed major hepatotoxicity; 8 out of 22 patients in the probable risk group developed major hepatotoxicity, representing an incidence of 12.5% and 36.4%, respectively. Patients in the major hepatotoxicity group were older (32.5 vs 24.2 years, p = 0.019), and had a longer time to presentation (28.1 vs 6.7 hours, p < 0.01) than those in the non/minor hepatotoxicity group. Multiple logistic regression revealed that age and time to presentation were independent risk factors for hepatotoxicity (p = 0.033 and p = 0.002, respectively). Conclusions: The results of outcome analysis confirm that the modified Rumack-Matthew nomogram has a high sensitivity for identifying Taiwanese patients at risk for acetaminophen-induced hepatoxicity. Patient age and time to presentation were independent risk factors for acetaminophen-induced hepatotoxicity.[SDGs]SDG3acetylcysteine; aminotransferase; paracetamol; adult; age; article; concentration (parameters); controlled study; drug blood level; drug intoxication; emergency ward; female; hospital admission; human; incidence; liver toxicity; logistic regression analysis; major clinical study; male; nomogram; outcomes research; retrospective study; risk assessment; risk factor; sensitivity analysis; Taiwan; time; Acetaminophen; Acetylcysteine; Adult; Analgesics, Non-Narcotic; Female; Hepatitis, Toxic; Humans; Male; Retrospective Studies; Risk Factors; Taiwanjournal article155491502-s2.0-12344288216