Treatment of Acetaminophen Toxicity With N-acetylcysteine

Treatment of Acetaminophen Toxicity With Intravenous vs Oral N-acetylcysteine: A Retrospective Review

Retrospective chart review of patients who received N-acetylcysteine for APAP toxicity to assess length of oral vs IV treatment and overall healthcare costs.

Inclusion Criteria:

• Admitted to CHMCA between June 1, 2004 to May 31, 2008 with a qualifying ICD-9 diagnosis code for the following APAP overdose situations; poisoning, accidental, suicide attempt, therapeutic use, assault, and undetermined (965.4, E850.4, E950.0, E935.4, E962.0, E980.0)
• Serum APAP concentrations ≥ 150 g/mL at 4 hours or a serum concentration above the possible hepatotoxic line on the Rumack-Matthew's nomogram if obtained > 4 hours post ingestion
• Between the ages of 0-21 years

Exclusion Criteria:

• Serum APAP concentrations are not actually documented
• Patient did not receive oral or IV NAC treatment
• Patient has a preexisting liver disease such as cirrhosis or hepatitis C
• Patient > 21 years of age