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Description:
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Acetaminophen is a dose -dependent toxin . Prognosis in severe acute liver injury is related presumably in part to the dose ingested . We sought to assess the value of acetaminophen dosing information in patients with acute liver failure due to acetaminophen toxicity to determine the role of dose as a prognostic indicator . Methods : Prospective data from 113 acute liver failure patients having single time point ingestions of acetaminophen were analyzed . Multivariate and chi -square tests were used to determine the relationship of dose to clinical outcome . We also used the Mann -Whitney U test to compare prognosis and survival in ALF with acetaminophen dose ingested . Results : Multivariate and chi -square analysis failed to show any relationship between acetaminophen dose and spontaneous survival . A separate analysis showed no correlation between acetaminophen dose and clinical prognostic indicators . Conclusions : Dose of acetaminophen ingested did not seem to play a role in prognosis . The most important prognostic factor was coma grade on admission to study . Acetaminophen dosing information is not always obtainable . When it is , it adds little to the clinical assessment . Severity of encephalopathy is a more reliable indicator of prognosis in these critically ill patients .
Keywords : acetaminophen ; acute liver failure ; hepatology ; xose ; outcome ; survival ; toxicity |