Characterization of patients with acute intoxication by paracetamol attended in the Children's Hospital Santísima Trinidad of Córdoba (2008-2018).

Abstract

Paracetamol (Acetaminophen) is an over-the-counter drug, present in most homes, becoming the leading cause of drug poisoning (accidental or voluntary) and acute liver failure in the world. Due to the frequency of presentation in pediatric emergency rooms and high morbidity and mortality of acute poisoning with Paracetamol, we set out to carry out this work.

To describe prevalence, toxic-epidemiological aspects and the clinical assistance of acute poisoning with Paracetamol in the Children's Hospital of Córdoba / HNC (2008-2018).

Observational, descriptive and retrospective study. From the records of the HNC Toxicology Service, were included children under 15 years of age that were diagnosed with acute paracetamol poisoning (2008-2018). Demographic, clinical and epidemiological variables were described. The numerical data were summarized using measures of central tendency and dispersion, and categorical data by frequency distribution and percentages (95% CI).

Final sample included 62 patients, all the poisonings occurred at home, predominantly in children under 5 years: 38/62 (61%), frequent "accidental" cause and adolescents: 22/62 (35.5%) prevalent cause the "suicide attempt". There was association with other drugs in 32 patients (51.6%) either by commercial formulas or by poly-drug intake. The majority did not show symptoms at the time of the consultation. Digestive decontamination was performed; only 30/62 (48%) blood acetaminophen dosage was required to decide therapeutic behaviors according to the Rumack-Matthew nomogram; 10 of them needed treatment with N-acetylcysteine. Only 18/62 required hospitalization for follow-up. No comorbidities or mortality were reported in any case.

Acute paracetamol poisoning continues to be frequent in our environment mainly in children under 5 years old (accidental cause) and in adolescents in a situation of self-harm. Commercial formulas with two or more drugs, free access of medicines in homes, irresponsible use, self-medication, as well as the lack of controls on their sale are the main factors associated with poisoning. It would be important to raise public awareness as well as deepen public health measures for the prevention and regulation of access and consumption of these substances.