Fatores associados à intoxicação por paracetamol: coorte retrospectiva de pacientes atendidos em um centro de referência toxicológico do nordeste

Abstract

Paracetamol, also called acetaminophen or N-acetyl-p-aminophenol, is the most used analgesic and antipyretic in the world, as it is considered a safe and effective drug when used in therapeutic doses. Despite this, studies have shown that paracetamol is an agent commonly used in suicide attempts, being one of the main causes of acute liver failure and the need for liver transplantation, in addition to being able to cause kidney damage in intoxicated individuals. Thus, the present study aims to carry out a retrospective cohort study to evaluate the factors associated with acetaminophen intoxication in patients, aged > 18 years and < 60 years, treated at a reference center for toxicology care in the Northeast between January 2015 and December. 2021. For this, the data from the medical records of the Brazilian System of Poisoning Data from the Centers for Toxicological Information and Assistance in Brazil (DATATOX) and the laboratory tests of the patients were stored in an electronic spreadsheet with the help of Excel®. The data obtained were analyzed in this program and in the Statistical Package for Social Science (SPSS) software for Macintosh version 23 (Armonk, NY: IBM Corp.), assuming p < 0.05 as a significance criterion. In addition, these same methodologies were used in the analysis of 3 groups constructed from the tertiles of paracetamol overdoses: G1 ≤ 8,308 mg; G2: > 8,308 mg and ≤ 19,080 mg; > 19,080 mg. The analysis of 43 patients showed that the population consisted mostly of females and young people with a mean age of 27 years. Most of the sample was characterized by ingesting paracetamol with other substances, by consuming the drug with suicidal intent and by having more gastrointestinal symptoms. The administration of the antidote N-acetylcysteine occurred more in patients who ingested high doses (>19,080 mg) of paracetamol and this was also the group that most had their liver parameters altered in the most critical context of hospitalized patients. Thus, from the data found, it is possible to identify the profile of patients and laboratory alterations that can be warning signs to help the health team in the clinical management that aims to benefit the good prognosis of the intoxicated in an earlier way, since liver damage markers may be lately evidenced.