Journal of The Korean Society of Clinical Toxicology (대한임상독성학회지)

Korean society of Clincal Toxicology (대한임상독성학회)
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Laboratory analysis of acute acetaminophen overdose patients in Emergency Medical Centers: including analysis of one toxicological laboratory data

응급의료센터에서 아세트아미노펜 과다복용 환자의 검사실 분석 현황: 일개 중독분석실 농도 분석자료 포함

  • Kim, In Chan (Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Won, Sinae (National Emergency Medical Center, National Medical Center) ;
  • Lee, Arum (Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Jung, Haeun (Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Jeongsun (Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Oh, Bum Jin (Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • 김인찬 (서울아산병원 응급의학과) ;
  • 원신애 (국립중앙의료원 중앙응급의료센터) ;
  • 이아름 (서울아산병원 응급의학과) ;
  • 정하은 (서울아산병원 응급의학과) ;
  • 이정선 (서울아산병원 응급의학과) ;
  • 오범진 (서울아산병원 응급의학과)
  • Received : 2020.11.03
  • Accepted : 2020.12.16
  • Published : 2021.06.30
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Abstract

Purpose: Acetaminophen (APAP) is a widely available drug responsible for a large part of drug-induced hepatotoxicity in developed countries. Although acetaminophen overdose cases in Korea are being continuously reported, there are no reports related to the level of this drug in the patient's blood or of laboratory analysis at emergency departments (ED). This study sought to analyze the acetaminophen overdose cases at a toxicological laboratory and to survey APAP analysis services offered at select EDs. Methods: We analyzed the demographic and analytic data at a toxicological laboratory run by the National Emergency Medical Center (NMC) in 2019-2020. We surveyed the APAP laboratory service in the 38 regional emergency medical centers (EMCs) and 68 local EMCs near the toxicological laboratory. Results: We studied 175 acute poisoning cases (112 women) with positive blood APAP results (mean age 47.0±24.1 years). Suicide attempts comprised 40.0% of the cases and 30.3% APAP overdose events. In the univariate analysis, we observed that patients were significantly younger, with fewer underlying medical diseases. There were a higher number of APAP overdose events, more favorable initial mental status, more toxic quantity intake in the above treatment line group (p<0.05), In multivariate analysis, the toxic amount intake was significantly more frequent in the above treatment line group (p<0.01). Hospital APAP analysis services were available in six EMCs (3/38 regional and 3/68 local). The hospital blood APAP level reporting intervals were shorter than outside-hospital laboratory services (p<0.01, regional 7.0±3.0 vs. 40.6±27.5, local 5.3±3.1 vs. 57.9±45.1 hours). The NMC toxicological laboratory reporting interval was shorter than the other outside-hospital laboratories (p<0.01, regional 5.7±0.6 vs. 50.2±22.7 local 7.5±3.0 vs. 70.5±41.5 hours). Conclusion: Over the treatment line group, toxic amount intake was significantly more frequent. Only six of 106 EMCs have their own APAP analysis service in their hospitals.

Keywords

Acknowledgement

이 논문은 국립중앙의료원 중앙응급의료센터에서 수행하는 보건복지부 사업(응급실 기반 급성중독환자 치료지원사업)의 결과를 분석하였습니다.

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