Sivilotti et al used the multiplication product of serum paracetamol and ALT concentrations to predict outcome in patients with hepatotoxicity from paracetamol overdose. The authors from the initial paper are from multiple institutions in Canada.
Patient selection: paracetamol overdose, treated with N-acetylcysteine
Outcome: serum ALT > 1.000 IU/L
molecular weight of acetaminophen: 151.163 g/mol
1 mg = 6.615 µmol
Parameters:
(1) initial serum paracetamol concentration in mg/L or µmol/L
(2) initial serum ALT concentration in IU/L
product =
= (serum paracetamol concentration) * (ALT)
Using mg/L
Using µmol/L
Risk of Hepatotoxicity
< 1,500 mg•IU/(L^2)
< 10,000 µmol•IU/(L^2)
very low
1,500 to 10,000
10,000 to 66,000
low to moderate
> 10,000 mg•IU/(L^2)
66,000 µmol•IU/(L^2)
high
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