From the Research
Highest Marker of Mortality in Acetaminophen Overdose
The highest marker of mortality in patients with acetaminophen (paracetamol) overdose can be identified through various studies. Key findings include:
- Post-resuscitation arterial lactate concentration has been shown to be a strong predictor of mortality in patients with paracetamol hepatotoxicity 1
- The King's College Hospital (KCH) criteria, which include factors such as lactate levels, are effective in predicting mortality in acetaminophen overdose patients 2
- A lactate level ≥3.5 mmol/L has been identified as a sensitive and early predictor of mortality in acetaminophen poisoning 2
- The combination of KCH criteria and lactate levels demonstrates high sensitivity and short latency in identifying patients who die from acetaminophen poisoning 2
Comparison of Prognostic Criteria
Different prognostic criteria have been compared in terms of their sensitivity and latency in predicting mortality in acetaminophen overdose patients. These include:
- King's College Hospital (KCH) criteria
- Model for End Stage Liver Disease (MELD) ≥33
- Lactate ≥3.5 mmol/L
- Phosphate ≥1.2 mmol/L 48+ hours post-ingestion
- Combinations of these criteria 2
Clinical Implications
The identification of high-risk patients with acetaminophen overdose is crucial for timely and effective treatment. The use of prognostic criteria such as lactate levels and KCH criteria can help clinicians predict mortality and make informed decisions about patient care. Additionally, the systemic inflammatory response syndrome (SIRS) and sequential organ failure assessment (SOFA) scores have been shown to be effective triage markers in paracetamol overdose patients 3