a Poison Information Centre, Helsinki University Hospital , Helsinki , Finland.
b Department of Transplantation and Liver Surgery , Abdominal Center, Helsinki University Hospital , Helsinki , Finland.
Clin Toxicol (Phila). 2018 Mar;56(3):209-215. doi: 10.1080/15563650.2017.1359619. Epub 2017 Aug 16.
Acetaminophen (APAP) or paracetamol is a commonly encountered medicine in poisonings. We studied the changes in APAP related calls to the Finnish poison information centre (FPIC), and serious intoxications, involving hepatotoxicity or death in 2001-2014. These data were compared with paracetamol sales in Finland.
This is a retrospective analysis of the FPIC database calls, national cause of death registry, registries of liver transplantations and molecular adsorbent recycling system (MARS)-treated patients from Helsinki University Hospital together with the National Institute of Health and Welfare registry of patients hospitalized. Data on APAP sales were obtained from the Finnish Medicines Agency.
Between 2001 and 2014, the number of calls/year related to human APAP exposures to the FPIC increased from 227 to 1058. No change in the age distribution of enquiries was seen. Most calls involved minors: 58% (range 52-64%) for children under 6 years old, and 9% (range 6-14%) for children of 6-15 years. In Finland, APAP related fatalities have gradually increased from an average of 7/year (range 4-10) in 2000-2005 to an average of 11/year (range 6-17) in 2010-2013, whereas the number of liver transplantations remained low, average 0.6/year (range 0-2). For patients in need of MARS-treatment, a slight decrease was seen. Total APAP sales increased from 5.6 (47% prescription, 53% OTC) to 29.7 (81% prescription, 19% OTC). DDD/1000 inhabitants/day from 2001 to 2014 is recorded. Best linear relationship (R = 0.97; p < .001) was observed between total FPIC calls and total sales of APAP in 2001-2014. Fatalities show a weaker relationship with sales (R = 0.317; p = .045).
During the study period, we see an increase in FPIC exposure calls accompanied by an increase in APAP sales. Changes in the chosen indicators for serious poisonings show only a weak association. Despite an evident trend between sales and fatalities, the correlation with fatality remains weak due to the small number of fatalities.
对乙酰氨基酚（APAP）或扑热息痛是中毒中常见的药物。我们研究了 2001-2014 年芬兰中毒信息中心（FPIC）与严重中毒相关的 APAP 相关电话，以及涉及肝毒性或死亡的中毒事件，这些事件与芬兰的扑热息痛销售情况进行了比较。
这是对 FPIC 数据库电话、国家死因登记处、肝移植登记处和赫尔辛基大学医院的分子吸附再循环系统（MARS）治疗患者以及国家卫生和福利研究所登记的住院患者进行的回顾性分析。APAP 销售数据来自芬兰药品管理局。
2001 年至 2014 年间，FPIC 与人类 APAP 暴露相关的电话数量/年从 227 个增加到 1058 个。咨询的年龄分布没有变化。大多数电话涉及未成年人：58%（范围 52-64%）为 6 岁以下儿童，9%（范围 6-14%）为 6-15 岁儿童。在芬兰，APAP 相关死亡人数逐渐增加，从 2000-2005 年平均每年 7 例（范围 4-10 例）增加到 2010-2013 年平均每年 11 例（范围 6-17 例），而肝移植数量仍然较低，平均每年 0.6 例（范围 0-2 例）。需要 MARS 治疗的患者人数略有下降。APAP 的总销售额从 5.6（47%处方，53% OTC）增加到 29.7（81%处方，19% OTC）。记录了 2001 年至 2014 年的 DDD/1000 居民/天。观察到 FPIC 总电话量与 2001-2014 年 APAP 总销售额之间存在最佳线性关系（R=0.97；p<0.001）。死亡率与销售额的关系较弱（R=0.317；p=0.045）。
在研究期间，我们发现 FPIC 暴露电话数量增加，同时 APAP 销售额增加。严重中毒选择指标的变化仅显示出微弱的关联。尽管销售与死亡之间存在明显趋势，但由于死亡人数较少，与死亡率的相关性仍然较弱。
