"Acetaminophen poisoning has become the most common cause of acute liver failure in the United States," reports a recent study published in the December issue of Hepatology, the official journal of the American Association for the Study of Liver Diseases.

The researchers conducted a prospective study of patients presenting with acute liver disease to any of 22 academic centers participating in the Acute Liver Failure Study Group. Of 662 consecutive patients over a six-year period between 1998 and 2003, 275 had acetaminophen-related acute liver failure. For each of these patients, the researchers gathered demographic and clinical information, including illness severity, history of acetaminophen ingestion, and outcome.
Study Findings:

• Acute liver failure cases attributed to acetaminophen increased from 28 percent in 1998 to 51 percent in 2003. These patients were predominantly female (74 percent) and Caucasian (88 percent.).
• While 44 percent had intentionally overdosed on the drug in suicide attempts, 48 percent had overdosed unintentionally, either by taking combinations of products containing acetaminophen, or taking more than the recommended dosage of a single product over time.
•  Of all patients with acetaminophen-related acute liver failure, 74 died, 23 received liver transplants, and 178 survived without transplantation.
• 63% percent of patients who overdosed accidentally had been using prescription narcotic/acetaminophen compounds. 38% percent had been using two acetaminophen medications simultaneously.
• Some patients reported taking less than 4 grams of acetaminophen per day before falling ill.

As a result of this study authors suggest that increase awareness of the use of over- the- counter pain killers, and improve labeling by manufacturers should be essential to decrease the unintentional poisoning of these pain killers.

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