[Deliberate self-poisoning with paracetamol (acetaminophen): an analysis from 1995 to 2002]

Paracetamol is frequently used in deliberate self-poisoning resulting in a major risk for the patients due to its dose-dependent hepatotoxicity. In the present study the cases of intoxications consulting our Poison Center should be analysed illustrating recent results and trends.

From 38 065 patients (25 098 female, 12447 male, 520 sex unknown, average age 36.8 years) registered during the study period from 1.1.1995 until 31.5.2002 4021 with paracetamol intoxication were analysed with respect to the ingested dose, concomitant substances, the degree of observed symptoms and the length of hospital stay.

The use of paracetamol in deliberate self-poisoning continuously increased during the study period from 8.9 % in the year 1995 to 12.4 % in 2002. Paracetamol was mainly used from female patients and patients in the age group between 10 and 29 years. 88.6 % of cases were reported to the poison center within the first twelve hours after ingestion. Concomitantly non-steroidal antirheumatics (38.0 %), ethanol (20.6 %) and antibiotics (15.0 %) were ingested. Monointoxications as well as mixed intoxications with paracetamol caused severe intoxications and deaths less frequently as compared to the group of the remainder substances with the degree of symptoms tended to be dose-dependent. In 73.7 % of cases the length of hospital stay did not exceed 3 days.

In recent years, an increasing importance of paracetamol in deliberate self-poisoning was determined particularly concerning female and younger patients. The dose of paracetamol and the duration of exposition are crucial for prognosis. With an early antidote therapy hospitalization is usually observed for a few days only. A risk for complications are frequently used concomitant substances requiring a detailed registration.