Poorer health for acetaminophen overdose survivors than other liver failure patients

Spontaneous survivors of acetaminophen overdose have significantly lower overall health compared to survivors or transplant recipients following acute liver failure caused by non-drug induced liver injury according to a new study published online in Liver Transplantation, a journal of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society. Findings show that acetaminophen overdose survivors report more days of impaired mental and physical health, and activity limitations due to poor health, pain, anxiety and depression.

Patients are diagnosed with (ALF) when severe occurs, along with blood clotting or bleeding disorders (coagulopathy) and compromised brain function (encephalopathy). Studies report that up to 3,000 patients develop ALF in the U.S. each year and 67% of these patients will survive, but nearly 30% of these patients require emergency liver transplantation. However, long-term consequences of ALF and health-related quality of life (HRQOL) of survivors, remains unclear.

To expand understanding of the quality of life and function of adult ALF survivors, a team led by Dr. Robert Fontana from the University of Michigan Medical Center in Ann Arbor conducted a prospective observational study. Patients diagnosed with ALF between January 1998 and July 2010 were included in the study. Participants agreed to follow-up at one and two years following ALF.

Results show that of the 282 ALF patients—125 liver transplantation recipients (10.7% due to acetaminophen overdose) and 157 spontaneous survivors of which 95 were acetaminophen overdose patients and 62 were survivors of non-drug induced liver failure. Patients that survived acetaminophen overdose reported significantly lower general health scores. Acetaminophen overdose survivors had higher rates of substance abuse and compared to non-acetaminophen overdose survivors and . Participants who were survivors of non-intentional acetaminophen overdose were less likely to have psychiatric comorbidity compared to patients who intentionally overdosed at 48% and 82%, respectively.

The combined group of spontaneous survivors of ALF reported "fair/poor" health and more than 14 days of physical or mental health impairment compared to the general population in the U.S. This group also had more limitation in functional activity due to poor health. "Our findings indicate that adult survivors of ALF have reduced quality of life compared to those of similar age and gender in the general population," concludes Dr. Fontana. "Additional investigations of by our team are underway to further understanding of the type and severity of cognitive impairment reported by ALF survivors."

This current study was funded in part by a grant from the National Institute of Diabetes, Digestive and Kidney Diseases (DK U-01-58369) to the United States Acute Liver Failure Study Group (ALFSG), which is led by Dr. William Lee, Professor of Internal Medicine at UT Southwestern Medical Center in Dallas. ALFSG is a National Institutes of Health-funded consortium of investigators in the United States focused on studying acute failure.

More information: "Quality of Life is Significantly Impaired in Long-Term Survivors of Acute Liver Failure and Particularly In Acetaminophen Overdose Patients." Amol S. Rangnekar, Caitlyn Ellerbe, Valerie Durkalski, Brendan McGuire, William M. Lee and Robert J. Fontana. Liver Transplantation; (DOI: 10.1002/lt.23688) Published Online: June 18, 2013.

add to favorites email to friend print save as pdf

Related Stories

Model predicts death due to acetaminophen overdose

Feb 24, 2012

(HealthDay) -- Model for Acetaminophen-induced Liver Damage (MALD), a mathematical model that utilizes commonly obtained laboratory values, including overdose amount and time elapsed since overdose, is effective ...

Recommended for you

Nigeria death shows Ebola can spread by air travel

10 hours ago

(AP)—Nigerian health authorities raced to stop the spread of Ebola on Saturday after a man sick with one of the world's deadliest diseases brought it by plane to Lagos, Africa's largest city with 21 million ...

Trial in salmonella outbreak to start in Georgia

10 hours ago

(AP)—Three people accused of scheming to manufacture and ship salmonella-tainted peanuts that killed nine people and sickened more than 700 are set to go to trial this week in Georgia.

Remote tribe members enter another village, catch flu

18 hours ago

Advocates for indigenous tribes are worried over incidents last month when some members of one of the last uncontacted tribes in the Peru/Brazil region, across borders, left their home in Peru and entered ...

Nigeria on red alert after first Ebola death

Jul 26, 2014

Nigeria was on alert against the possible spread of Ebola on Saturday, a day after the first confirmed death from the virus in Lagos, Africa's biggest city and the country's financial capital.

User comments