4CPS-228 Acute hepatitis after paracetamol poisoning: analysis of potentially influencing factors

<h3>Background and Importance</h3> Acute hepatitis (AH) is the acute inflammation and necrosis of the liver parenchyma. Among its many causes is paracetamol poisoning (PP). Inflammatory parameters usually begin to rise within 24–48 hours, the unfavourable course of AH predisposes to acute liver failure. <h3>Aim and Objectives</h3> Analysis of the prevalence of AH after PP. To identify which epidemiological and intoxication-associated variables are related to the development of AH, and to examine the degree of correlation. <h3>Material and Methods</h3> This observational, retrospective, descriptive study examined patients treated with N-acetylcysteine in the ED for PP between January-2019 and August-2024. AH was defined as a set of non-specific gastrointestinal symptoms, asthenia or abdominal pain in conjunction with elevated Aspartate-aminotransferase (x10 times the upper normal limit), Bilirubin (&gt;2.5mg/dL) and, in severe cases, coagulopathy (INR&gt;1.5). The analytical test conducted at the conclusion of the N-acetylcysteine (NAC) perfusion and 48 hours post-poisoning was reviewed to ascertain whether there was evidence of AH. Potential risk factors for paracetamol hepatotoxicity (PRFPH) included: chronic alcoholism, malnutrition, drugs that increased the oxidative metabolism of paracetamol. It was examined: Variables related to PP: age, sex, PRFPH, massive paracetamol intake (considered as &gt;30g), time between PP and starting of NAC treatment. Variables related to NAC treatment according to the centre’s protocol: dosage, preparation, administration, and infusion duration. The relationship between the variables under examination and the onset of AH was investigated through the Chi-squared test, significance level (p&lt;0.05). <h3>SPSSv</h3> 27 was used for statistical analysis. <h3>Results</h3> A total of 43 patients (72.1% female) were studied. The median age was 19 years, (IQR=10). The prevalence of patients with HA was 6.9%. The 20.9% of patients presented with PRFPH, none of them developed AH. NAC was inappropriately used in 55.8% of total patients and in 66.6% of AH patients, (p&gt;0.05). In two of three AH patients, paracetamol ingestion was &gt;30g and the start of NAC was 8 hours after PP, (p=0.003). <h3>Conclusion and Relevance</h3> PP was predominantly observed in young female patients. The prevalence of AH was low, however, there was a statistically significant association between AH and both massive intakes and delayed initiations of NAC. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest