Nearly half reached hospital more than a day after the overdose
Of 663 admissions for severe paracetamol liver injury, 45% of those who took a single overdose arrived more than 24 hours later, at 2.25 times the odds of death or transplant.
What the study found
Arriving a day late doubled the odds of death or transplant
Of 663 admissions for severe paracetamol liver injury at a Scottish transplant unit, 45% of single-overdose patients arrived more than 24 hours later, at odds of death or transplant of 2.25. A separate group had got there by repeated smaller doses, most often taken for pain.
The caveat · One transplant unit, 1992 to 2008
One specialist transplant unit between 1992 and 2008, so these are the most severe cases and the mortality figures are not overdose mortality generally. Ingestion times and patterns were reconstructed from records after the fact. The repeat-dose group did die more often, 37.3% against 27.8%, but that gap did not hold up once age and alcohol misuse were accounted for, so it travels with those rather than clearly causing the worse outcome. Treatment of both patterns has changed since.