Journal of The Korean Society of Clinical Toxicology (대한임상독성학회지)

Korean society of Clincal Toxicology (대한임상독성학회)
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Is it Adequate to Determine Acetaminophen Toxicity Solely on Patients' History? An Analysis on Clinical Manifestation of Intoxication Patients with Positive Serum Acetaminophen Concentrations

환자의 아세트아미노펜 중독 여부를 환자진술 만으로 확인하는 것이 타당한가?: 혈중에서 아세트아미노펜이 검출된 환자의 임상 양상 분석

  • Kim, Jee Hyun (Department of Emergency Medicine, Chungnam National University Hospital) ;
  • Jeong, Won-joon (Department of Emergency Medicine, Chungnam National University Hospital) ;
  • Ryu, Seung (Department of Emergency Medicine, Chungnam National University Hospital) ;
  • Cho, Yong Chul (Department of Emergency Medicine, Chungnam National University Hospital) ;
  • Moon, Jang Hyuck (Department of Emergency Medicine, Chungnam National University Hospital) ;
  • Choi, Hyun Soo (Department of Emergency Medicine, Chungnam National University Hospital) ;
  • Yang, Song Hee (Graduate School of Analytical Science and Technology, Chungnam National University) ;
  • Chung, Hee Sun (Graduate School of Analytical Science and Technology, Chungnam National University)
  • 김지현 (충남대학교병원 응급의학과) ;
  • 정원준 (충남대학교병원 응급의학과) ;
  • 유승 (충남대학교병원 응급의학과) ;
  • 조용철 (충남대학교병원 응급의학과) ;
  • 문장혁 (충남대학교병원 응급의학과) ;
  • 최현수 (충남대학교병원 응급의학과) ;
  • 양송희 (충남대학교 분석과학기술대학원) ;
  • 정희선 (충남대학교 분석과학기술대학원)
  • Received : 2017.08.31
  • Accepted : 2017.09.25
  • Published : 2017.12.31
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Abstract

Purpose: Acute acetaminophen intoxication is a common occurrence that can cause lethal complications. In most domestic emergency departments, clinicians tend to treat acetaminophen intoxication based on patients' history alone, simply due to the lack of a rapid acetaminophen laboratory test. We performed a 20-month study of intoxication patients to determine the correlation between the history of patients and serum laboratory tests for acetaminophen. Methods: We took blood samples from 280 intoxication patients to evaluate whether laboratory findings detected traces of acetaminophen in the sample. Patients were then treated according to their history. Laboratory results came out after patients' discharge. Agreement between patients' history and laboratory results were analyzed. Results: Among the 280 intoxicated patients enrolled, 38 patients had positive serum acetaminophen concentrations; 18 out of 38 patients did not represent a history suggesting acetaminophen intoxication. One patient without the history showed toxic serum acetaminophen concentration. Among the patients with the history, two patients with toxic serum acetaminophen concentration did not receive N-acetylcysteine (NAC) treatment due to their low reported doses, while other 2 patients without significant serum acetaminophen concentration did receive NAC treatment due to their high reported doses. Conclusion: This study showed a good overall agreement between history and laboratory test results. However, some cases showed inconsistencies between their history and laboratory test results. Therefore, in treating intoxication patients, a laboratory test of acetaminophen with rapid results should be available in most domestic emergency departments.

Keywords

References

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