Decision Rule - King's College Criteria for Acetaminophen Toxicity

King’s College Criteria for Acetaminophen Toxicity

-Arterial pH <7.30  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  [No/Yes]

-INR >6.5 (PT >100 seconds) . . . . . . . . . . . . . . . . . . . . . . . .  [No/Yes]

-Creatinine 3.4 mg/dL (300 µmol/L) . . . . . . . . . . . . . . . . . . . . [No/Yes]

-Grade III or IV hepatic encephalopathy  . . . . . . . . . . . . . . . .  [No/Yes]

The presence of any of the above should prompt referral and possible transfer to a center capable of liver transplantation.

Other predictors of a poor prognosis without transplant:

-Lactate >3.5 mmol/L after fluid resuscitation (<4 hours)  . . .  [No/Yes]

-Lactate >3 mmol/L after full fluid resuscitation (12 hours) . .  [No/Yes]

-Phosphate >3.75 mg/dL (1.2 mmol/L) at 48-96 hours . . . . .  [No/Yes]

https://www.mdcalc.com/kings-college-criteria-acetaminophen-toxicity

https://www.mdcalc.com/hepatic-encephalopathy-grades-stages