Gender differences in acetaminophen-induced acute liver failure
Miller J, Baltarowich L, Gardner-Gray J, Hurst G, Pflaum-Carlson J, Varma A, Brown K, and West JR. Gender differences in acetaminophen-induced acute liver failure. Acad Emerg Med 2019; 26:S171.
Acad Emerg Med
Background: The rate of acetaminophen-induced acute liver failure (Apap-ALF) has risen substantially. Our primary objective was to test differences in presentation and outcomes of Apap-ALF based on gender. We secondarily tested whether obesity may affect survival. Methods: We performed a retrospective observational study inclusive of Apap-ALF cases over a 12-year period from a regional transplant center. All case data was composed with standardized data collection tools by trained abstractors. We defined ALF by the presence of AST and ALT ≥ 1000 U/L and an INR ≥ 2.0. We excluded cases without Apap ingestion. Univariate analysis compared clinical characteristics and 28-day transplant-free survival based primarily on gender. We also performed multivariate logistic regression to include obesity (body mass index > 30), age, and sequential organ failure assessment (SOFA) score. Results: There were 327 patients included, of whom most were female (67%). Women had similar age (39 ±14 vs. 40 ±16 years) and comorbidities to men, but were less likely to have a history of alcohol use (34% vs. 63%, p