TY - JOUR AU - มะซัน, ฮาริส AU - หล่อตระกูล, มาโนช AU - จุลเกตุ, สุดาวรรณ PY - 2019/06/28 Y2 - 2024/03/29 TI - Characteristics of Patients with Paracetamol Overdose and Principal Risk Factor for Severe Hepatotoxicity JF - Journal of the Psychiatric Association of Thailand JA - J Psychiatr Assoc Thailand VL - 64 IS - 2 SE - Original Articles DO - UR - https://he01.tci-thaijo.org/index.php/JPAT/article/view/198822 SP - 127-138 AB - <p>Objectives : To study characteristics and risk factors for severe hepatotoxicity among paracetamol<br>overdose patients who were treated at Ramathibodi Hospital from 2007 to 2016.<br>Methods : This is a retrospective descriptive study of patients who were diagnosed with<br>“paracetamol overdose” (ICD-10: T391) between 1 January 2007 and 31 December 2016. Data<br>were collected from Patients’ Record and Medical Informatics Division, Ramathibodi Hospital.<br>Results : A total 105 patients were diagnosed with paracetamol overdose. The majority of patients<br>were female students between the age of 21–39 with non-marital status and holding a bachelor’s<br>degree or higher. The motivation for paracetamol overdose was to commit suicide and self-harm<br>(49.42%), driven by relationship problems (67.44%) and most of them had suicidal attempts before<br>(66.67%). Most overdoses were impulsive attempts (91.95%) with no previous history of psychiatric<br>illnesses (84.95%). 58.25 percent of them were diagnosed with adjustment disorders. Laboratory<br>tests indicating severe hepatotoxicity were AST, ALT, PT, PTT and INR, whereas ALP played<br>insignificant role. Paracetamol blood level did not correlate with the severity of hepatotoxicity. The<br>major risk for hepatotoxicity is the time between paracetamol ingestion and visiting the emergency<br>room. Patients who visited the emergency room later than 8 hours after paracetamol ingestion<br>had a 20.9 time higher risk for hepatotoxicity compared to those who visited earlier (95% CI<br>5.476-79.682, p-value &lt; 0.001). The hospitalization period of patients with severe hepatotoxicity<br>is significantly higher than those without severe hepatoxicity.<br>Conclusion : Most cases of paracetamol overdose were impulsive acts of self-harm. The chance<br>of developing severe hepatotoxicity is low if patients came earlier after drug ingestion. It is crucial<br>to promote social awareness of the importance of receiving prompt treatment after paracetamol<br>overdose as this helps reduce the rate of severe hepatoxicity. It will also reduce unnecessary uses<br>of resources, including expenses, time, and medical personnel.</p> ER -