Objective
To describe and compare the characteristics of paracetamol poisoning in adolescent and adult patients.
Method
Descriptive retrospective case series of adolescent (12–17 years) and adult (>18 years) patients presenting to a metropolitan hospital network ED, diagnosed with paracetamol poisoning from October 2009 to September 2013.
Results
There were 220 adolescent (median age 16 years, 47% treated with acetylcysteine [NAC]) and 647 adult presentations (median age 27 years, 42% treated with NAC) for paracetamol poisoning in the study period. Adolescent patients were more frequently women (89% vs 76%; odds ratio [OR] 2.4; 95% confidence interval [CI] 1.5–3.8) and ingested similar amounts of paracetamol (18 g) when requiring NAC treatment. Adolescents were more likely to ingest paracetamol as a single agent (53% vs 34%; OR 2.2; 95% CI 1.6–3.0) and less likely to ingest compound paracetamol products than adults (18% vs 29%; OR 0.54; 95% CI 0.36–0.79). Adolescents were less likely to report accidental supratherapeutic ingestion of paracetamol (0.02% vs 10%; OR 0.23; 95% CI 0.09–0.58), or co‐ingestion of prescription medications (25% vs 43%; OR 0.4; 95% CI 0.31–0.62). Adolescents had more frequent histamine release reactions to NAC than adults (17% vs 8%; OR 2.3; 95% CI 1.2–4.5). No cases required liver transplantation or resulted in death.
Conclusion
Adolescents ingested comparable amounts of paracetamol to adults, when presenting with deliberate self‐poisoning. However, there were significant differences in co‐ingested medications and the reason for ingestion of paracetamol. Histamine reactions to NAC were more common in adolescents; however, most were mild. Overall, outcome was favourable in both cohorts.