Evaluation and Comparison of Patients Poisoning with Acetaminophen and Nonsteroidal Anti-Inflammatory Drugs

INTRODUCTION: We aimed to determine and compare the clinical and demographical features, treatments, follow-ups, poisoning scores and outcomes of cases with the acetaminophen and NSAIDs intoxication.
METHODS: Data of the patients who were at the age of 18 and older and applied to the Emergency Department with the acetaminophen or NSAIDs intoxication were retrospectively examined. The cases were divided into 2 groups as the acetaminophen and NSAIDs group. The cases’ age, gender, drug amount, hospitalization status and periods, poisoning scores (PSS, APACHE-II) and last conditions in discharging from the hospital were compared.
RESULTS: The dose taken by 99 (55%) patients in the acetaminophen group was calculated as toxic, the intravenous acetylcysteine was administered to 70 (38.9%) patients as an antidote. When the APACHE-II scores of the patients hospitalized in the intensive care unit were examined, the mean APACHE-II score of 54 patients in the acetaminophen group was 3.15±3.70, the mean APACHE-II score of 34 patients in the NSAIDs group was 4.15±3.13 and it was statistically higher (p=0.031). All the patients followed-up in both groups were discharged with healing except only 1 (0.6%) patient who developed acute liver failure.
DISCUSSION AND CONCLUSION: The mean APACHE-II score was low in both groups. Therefore, following-up the patients in a unit such as a toxicology unit instead of the intensive care unit can be beneficial in terms of both reducing the place and labor force loads and cost. Moreover, the acetylcysteine treatments in the early period of the acetaminophen toxicity are very effective in decreasing the mortality and morbidity.