In a recent metanalysis of studies examining whether the paracetamol x transferase multiplication product predicted hepatotoxicity after paracetamol overdose, the authors analyzed 5,036 participants as an entire group and as subgroups. This product was particularly helpful in ruling out hepatotoxicity in which presentation: single acute ingestion; staggered ingestion; before eight hours from ingestion, or after eight hours from ingestion?
The lower limit multiplication product of 1,500 mg/L x IU/L in the staggered ingestion, was 100% sensitive at predicting who will eventually develop hepatoxicity.
Chun En Yau, Haoyang Chen, Bryant Po-Yuen Lim, Mingwei Ng, R. Ponampalam, Daniel Yan Zheng Lim, Yip Han Chin & Andrew Fu Wah Ho (2022) Performance of the paracetamol-aminotransferase multiplication product in risk stratification after paracetamol (acetaminophen) poisoning: a systematic review and meta-analysis, Clinical Toxicology, DOI: 10.1080/15563650.2022.2152350