P-46 EPIDEMIOLOGICAL PROFILE AND CLINICAL OUTCOMES OF PATIENTS INTOXICATED WITH ACETAMINOPHEN FOR SUICIDAL PURPOSES AT HOSPITAL SAN VICENTE FUNDACIÓN RIONEGRO: A CASE SERIES

Abstract

Introduction: Acetaminophen is the most widely used analgesic in the world and its overdose is a major cause of hepatic failure in developed countries. Objective: This study aims to describe patients with overdose intake of acetaminophen between 2019 and 2020 at a reference center for liver transplantation in Rionegro-Colombia. Methods: Case-series study derived from a secondary analysis of the clinical records between January 1st of 2019 to December 31st of 2020. Inclusion criteria were individuals with voluntary acute ingestion of toxic doses of acetaminophen (>4 g/day). Results: 63 cases, 68% women, 67% <18-year-old, and 54% students. 60% had a personal history of psychiatric illness and 35% reported at least one previous suicide attempt. The median dose of acetaminophen was 15g (IQR:11.5g; Max:50g), 46% referred to co-ingestion with other substances and 13% were under the effect of any psychoactive substance. 57% had a clear intention of suicide. 81% vomited before the arrival to the emergency room, 22% received decontamination intervention with gastric lavage or activated charcoal, and 10% did not receive any dose of N-Acetylcysteine. 15 individuals developed an acute liver injury, 9 with severity criteria, and 1 developed acute kidney injury. Conclusions: The population was predominantly young, the personal history of psychiatric disease was highly prevalent, and most of the cases referred to a vital event that explains the impulsive behavior in acetaminophen consumption. No one developed criteria for liver transplantation and this could be explained by the young age of the individuals, the episodes of early vomiting, and the absence of chronic liver disease or hepatotoxic substance consumption.