Characteristics and outcomes of paracetamol poisoning cases at a general hospital in Northern Malaysia

Mohd Zain Z, Fathelrahman AI, Ab Rahman AF
Correspondence: Dr Ab Rahman A F, abfatahmy@yahoo.com

ABSTRACT
Introduction Paracetamol is available as an over-the-counter medication in many countries including Malaysia. This drug has been implicated in many poisoning cases admitted to hospitals throughout the country.
Methods We conducted a three-year retrospective review of 165 medical records of patients admitted to the Penang General Hospital for acute paracetamol poisoning. Cases were identified according to the discharge diagnosis documented in their medical records.
Results Acute paracetamol poisoning occurred in all major ethnic groups. About 70 percent of our patients were female. There was minimal involvement of children. Admissions were more likely to be due to deliberate ingestions rather than accidental poisoning. In most cases, serum concentrations data plotted on the Rumack-Matthew nomogram predicted the majority of cases to be unlikely to be hepatotoxic, which were consistent with their mild clinical courses. Patients who acutely ingested more than 140 mg/kg or predicted to be hepatotoxic, based on their serum concentrations, had a significantly longer hospital stay.
Conclusion Although acute paracetamol poisoning was common, the outcome was generally good.

Keywords: acute poisoning, drug ingestion, paracetamol, poisoning
Singapore Med J 2006; 47(2): 134-137