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Assessing the impact of vomiting episodes on outcome after acetaminophen poisoning

Sa'ed H Zyoud1, Rahmat Awang, Syed Azhar Syed Sulaiman

  • 1WHO Collaborating Centre for Drug Information, National Poison Centre, Universiti Sains Malaysia (USM), Penang, Malaysia. saedzyoud@yahoo.com

Basic & Clinical Pharmacology & Toxicology
|May 12, 2010
PubMed

Insights

Vomiting is common in acetaminophen poisoning and may indicate a higher risk of kidney and liver damage. Increased vomiting episodes at presentation signal potential organ toxicity.

Area of Science:

  • Toxicology
  • Clinical Medicine
  • Prognostic Markers

Background:

  • Acetaminophen (paracetamol) overdose is a frequent cause of acute liver injury.
  • Identifying early indicators of poor prognosis is crucial for effective clinical management and targeted interventions.

Purpose of the Study:

  • To determine the prevalence, characteristics, and predictors of vomiting in acetaminophen poisoning.
  • To investigate the association between vomiting episodes upon initial presentation and patient outcomes.

Main Methods:

  • Retrospective cohort study of 291 patients admitted within 24 hours of acetaminophen ingestion.
  • Data collected over a 5-year period (2004-2008).
  • Statistical analysis included parametric and non-parametric tests; logistic regression identified risk factors.

Main Results:

  • Vomiting occurred in 65.3% of patients at initial presentation.
  • Risk factors for vomiting included acetaminophen dose ≥10 g and latency >8 hours.
  • Increased vomiting episodes correlated with elevated prothrombin time, bilirubin, creatinine, potassium, longer hospital stay, and higher serum acetaminophen levels.

Conclusions:

  • Vomiting is a prevalent symptom in acetaminophen poisoning.
  • An increased number of vomiting episodes at first presentation serves as a significant risk marker for subsequent nephrotoxicity and hepatotoxicity.

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