Math Can Save Tylenol Overdose Patients

Photo: Math blackboard

University of Utah mathematicians
with some of the calculus
equations that are part of a new
method they developed and
tested to make it easier for
doctors to save Tylenol
overdose patients by quickly
determining if they can be
saved with an antidote or will
require a liver transplant to
survive; © panthermedia.net/
kudryashka

"It is an opportunity to use mathematical methods to improve medical practice and save lives," says Fred Adler, co-author of a study that developed and tested the new method.

Adler and colleagues showed that using only four common medical lab tests – known as AST, ALT, INR and creatinine – the equations can quickly and accurately predict which Tylenol overdose patients will survive with medical treatment and which will die unless they receive a liver transplant.

The researchers analysed the records of 53 acetaminophen overdose patients treated at the University of Utah's University Hospital to test the equations and show they quickly and accurately predicted, in retrospect, which patients survived and which died. Speed is essential in listing acute liver failure patients as candidates for transplant, says study co-author Norman Sussman.

If a doctor is uncertain and starts to treat an acetaminophen-poisoning patient with the antidote to combat liver failure – even though the patient may not survive with such medicine – their odds for getting a new liver are reduced.

"If I wait another day until I list them for transplant, the chance of getting a liver is that much lower," Sussman says. "If you are going to get someone transplanted, you have to do it fast or you miss the boat. The patient may pass the window when transplants can be done. They become too sick and cannot stand the transplant."

The new method using calculus equations will let doctors rapidly determine if a patient can survive with antidote treatment or will die unless they get a transplant. The study urges another clinical trial to prove the new method's usefulness. Sussman plans to start a one-year prospective trial testing the method on 50 patients at the University of Utah and three hospitals in Houston.

If that trial proves the method can accurately predict ahead of time how Tylenol-poisoning patients will fare, "we believe we could create a tool available and immediately useful to clinicians," Sussman says.

Acetaminophen – the primary generic name for the drug also known generically as APAP and paracetemol – is found in prescription medicines such as Tylenol with Codeine, Percocet or Vicodin, and in dozens of over-the-counter medications, including Tylenol, Anacin, Pediacare, Triaminic and combination cold medications like Nyquil.

MEDICA.de; Source: University of Utah