Age-Related Changes in the Hepatic Pharmacology and Toxicology of Paracetamol

Table 3

Selected reports of paracetamol-related hepatotoxicity, deaths, and transplantsin the United States, Canada, United Kingdom, Malaysia, and Australia for the period 1989–2010. Only studies that have included a sub grouping for “older adults”, defined as those aged > 60 years, are included.

Source	Approximate population Size	Cases/million population/year	% of Reports for those aged years	% of Reports unintentional	Reference
Spontaneous ADR reports, AUS1990–2010	17–22.5 million	0.04 deaths	37.5% deaths	NR	Pers. Comm. Graeme Harris, ACSOM, 24/8/2010
Ballarat Hospital Records, AUS 2000–2003	0.2 million	240 hospitalisations	2.6% hospitalisations	4.7%	[56]
Penang General Hospital, Malaysia 2000–2002	Approx 1.3 million	42.3 cases of poisoning	1.2% of poisoning cases	33.3%	[57]
Calgary, Canada1995–2004	1.1 million	140.2 hospitalisations	4.5% hospitalisations	13%	[58]
US Transplant Centres1998–2001	17 tertiary care centres	NR	6% ALFs6.8% deaths	57% ALFs	[59]
US 1990–2001	250 million	1.83 deaths	4% hospitalisations 14% deaths	23 % hospitalisations22% deaths	[60]
Cardiff, UK 1989–2002	Approx 2.9 million	185 hospital admissions	1.6 % of admissions in adults 60–69 years1.8% of admissions in adults >70 years	All intentional	[61]
England and Wales 1993–1998	NR	15720 deaths, 13% due to paracetamol alone, 5.8% due to paracetamol and other drugs	11.5% deaths per million males during 1993–199814.2% deaths per million females during 1993–1998	NR	[62]

NR, not reported; US, United States; UK, United Kingdom; AUS, Australia; ADR, adverse drug reaction; ACSOM, Advisory Committee on the Safety of Medicines; ALF, acute liver failure; APAP, paracetamol.