ArticleJournal of medical toxicology : official journal of the American College of Medical Toxicology2016
Comparison of Prothrombin Time and Aspartate Aminotransferase in Predicting Hepatotoxicity After Acetaminophen Overdose.
Article in Journal of medical toxicology : official journal of the American College of Medical Toxicology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 16 citations in OpenAlex.
- Patterns of acetaminophen toxicity among patients with low-risk serum concentrations.The Journal of international medical research · 2024Article
- Plasma Concentration of Taurine Changes following Acetaminophen Overdose in Male Patients during Hospitalization.Iranian journal of pharmaceutical research : IJPR · 2021Article
- Anti-Inflammatory and Anticoagulant Activities of Synthesized NSAID Prodrug Esters.Scientifica · 2020Article
- Biomarkers of drug-induced liver injury.Advances in pharmacology (San Diego, Calif.) · 2019Review
- Comparison of Prothrombin Time and Aspartate Aminotransferase in Predicting Hepatotoxicity After Acetaminophen Overdose: a Response.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2016Article
- In Response to: "Comparison of Prothrombin Time and Aspartate Aminotransferase in Predicting Hepatotoxicity After Acetaminophen Overdose.".Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2016Article
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Authors and funding
4 authors at 3 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
Despite decades of experience with acetaminophen (APAP) overdoses, it remains unclear whether elevated hepatic transaminases or coagulopathy develop first. Furthermore, comparison of the predictive value of these two variables in determining hepatic toxicity following APAP overdoses has been poorly elucidated. The primary objective of this study is to determine the test characteristics of the aspartate aminotransferase (AST) and the prothrombin time (PT) in patients with APAP toxicity. A retrospective chart review of APAP overdoses treated with IV N-acetylcysteine at a tertiary care referral center was performed. Of the 304 subjects included in the study, 246 with an initial AST less than 1000 were analyzed to determine predictors of hepatic injury, defined as an AST exceeding 1000 IU/L. The initial AST >50 was 79.5 % sensitive and 82.6 % specific for predicting hepatic injury. The corresponding negative and positive predictive values were 95.5 and 46.3 %, respectively. In contrast, an initial abnormal PT had a sensitivity of 82.1 % and a specificity of 63.6 %. The negative and positive predictive values for initial PT were 94.9 and 30.2 %, respectively. Although the two tests performed similarly for predicting a composite endpoint of death or liver transplant, neither was a useful predictor. Initial AST performed better than the initial PT for predicting hepatic injury in this series of patients with APAP overdose.
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