Clinical And Toxicological Aspects Associated With Paracetamol Poisoning And Predictors Of Its Outcomes

Paracetamol is a common source of poisoning, and early identification of patients with more severe poisoning is the key to improving outcomes. Many aspects of paracetamol toxicity and treatment remain poorly understood. To improve knowledge about paracetamol poisoning, the current 5-year, hospital-b...

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Main Author: Zyoud, Sa'ed H. A.
Format: Thesis
Language:English
Published: 2011
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Online Access:http://eprints.usm.my/45679/1/SAED%20H.%20A.%20ZYOUD_HJ.pdf
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spelling my-usm-ep.456792019-10-17T07:24:23Z Clinical And Toxicological Aspects Associated With Paracetamol Poisoning And Predictors Of Its Outcomes 2011-12 Zyoud, Sa'ed H. A. R5-920 Medicine (General) Paracetamol is a common source of poisoning, and early identification of patients with more severe poisoning is the key to improving outcomes. Many aspects of paracetamol toxicity and treatment remain poorly understood. To improve knowledge about paracetamol poisoning, the current 5-year, hospital-based study was carried out with the following primary objectives (1) to determine the pattern of paracetamol poisoning among patients who were admitted to Hospital Pulau Pinang (HPP); and (2) to identify indicators of poor prognosis at first hospital presentation for improving clinical care and determining intervention targets for prevention, early detection, diagnosis and treatment. This is an observational retrospective cohort study of hospital admissions for acute paracetamol poisoning between 1 January 2004 and 31 December 2008. Overall, 305 patients met the inclusion criteria. Gastrointestinal (GI) manifestations were common in patients who reported ingestion of ≥ 8 g of paracetamol, and whose latency was longer than 8 hours; and both of these factors were identified as strong independent predictors of the presence of GI manifestations, especially nausea/vomiting. The presence of GI symptoms was a significant marker of poor outcomes and increased hospital stays. Additionally, hypokalaemia is highly associated with paracetamol poisoning. Specific clinical characteristics upon first presentation to the hospital, such as vomiting, psychiatric illness, and reported paracetamol dose ingested, can be used to identify patients at increased risk for hypokalaemia. Importantly, long hospital stays were significantly less frequent when IV-NAC therapy was administered within 8 hours of paracetamol ingestion (p = 0.006). 2011-12 Thesis http://eprints.usm.my/45679/ http://eprints.usm.my/45679/1/SAED%20H.%20A.%20ZYOUD_HJ.pdf application/pdf en public phd doctoral Universiti Sains Malaysia Pusat Racun Negara
institution Universiti Sains Malaysia
collection USM Institutional Repository
language English
topic R5-920 Medicine (General)
spellingShingle R5-920 Medicine (General)
Zyoud, Sa'ed H. A.
Clinical And Toxicological Aspects Associated With Paracetamol Poisoning And Predictors Of Its Outcomes
description Paracetamol is a common source of poisoning, and early identification of patients with more severe poisoning is the key to improving outcomes. Many aspects of paracetamol toxicity and treatment remain poorly understood. To improve knowledge about paracetamol poisoning, the current 5-year, hospital-based study was carried out with the following primary objectives (1) to determine the pattern of paracetamol poisoning among patients who were admitted to Hospital Pulau Pinang (HPP); and (2) to identify indicators of poor prognosis at first hospital presentation for improving clinical care and determining intervention targets for prevention, early detection, diagnosis and treatment. This is an observational retrospective cohort study of hospital admissions for acute paracetamol poisoning between 1 January 2004 and 31 December 2008. Overall, 305 patients met the inclusion criteria. Gastrointestinal (GI) manifestations were common in patients who reported ingestion of ≥ 8 g of paracetamol, and whose latency was longer than 8 hours; and both of these factors were identified as strong independent predictors of the presence of GI manifestations, especially nausea/vomiting. The presence of GI symptoms was a significant marker of poor outcomes and increased hospital stays. Additionally, hypokalaemia is highly associated with paracetamol poisoning. Specific clinical characteristics upon first presentation to the hospital, such as vomiting, psychiatric illness, and reported paracetamol dose ingested, can be used to identify patients at increased risk for hypokalaemia. Importantly, long hospital stays were significantly less frequent when IV-NAC therapy was administered within 8 hours of paracetamol ingestion (p = 0.006).
format Thesis
qualification_name Doctor of Philosophy (PhD.)
qualification_level Doctorate
author Zyoud, Sa'ed H. A.
author_facet Zyoud, Sa'ed H. A.
author_sort Zyoud, Sa'ed H. A.
title Clinical And Toxicological Aspects Associated With Paracetamol Poisoning And Predictors Of Its Outcomes
title_short Clinical And Toxicological Aspects Associated With Paracetamol Poisoning And Predictors Of Its Outcomes
title_full Clinical And Toxicological Aspects Associated With Paracetamol Poisoning And Predictors Of Its Outcomes
title_fullStr Clinical And Toxicological Aspects Associated With Paracetamol Poisoning And Predictors Of Its Outcomes
title_full_unstemmed Clinical And Toxicological Aspects Associated With Paracetamol Poisoning And Predictors Of Its Outcomes
title_sort clinical and toxicological aspects associated with paracetamol poisoning and predictors of its outcomes
granting_institution Universiti Sains Malaysia
granting_department Pusat Racun Negara
publishDate 2011
url http://eprints.usm.my/45679/1/SAED%20H.%20A.%20ZYOUD_HJ.pdf
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