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Study Title and Description

Fatal caffeine overdose: a case report and review of literature.



Key Questions Addressed
1 For [population], is caffeine intake above [exposure dose], compared to intakes [exposure dose] or less, associated with adverse effects on acute toxicity*?
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Primary Publication Information
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TitleData
Title Fatal caffeine overdose: a case report and review of literature.
Author SB Jabbar,MG Hanly,
Country
Year 2013
Numbers

Secondary Publication Information
There are currently no secondary publications defined for this study.


Extraction Form: Acute Toxicity - Study Design Details
Arms
No arms have been defined in this extraction form.

Design Details
Question... Follow Up Answer Follow-up Answer
Refid 24196726
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What outcome is being evaluated in this paper? Acute
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What is the objective of the study (as reported by the authors)? We report a case of fatal caffeine overdose in a 39-year-old man resulting from the self-administered ingestion of approximately 12 g of pure caffeine anhydrous. Autopsy blood caffeine levels were 350 mg/L.
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Provide a general description of the methods as reported by the authors. Information should be extracted based on relevance to the SR (i.e., caffeine related methods) NA - case report
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How many outcome-specific endpoints are evaluated? 1
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What is the (or one of the) endpoint(s) evaluated? (Each endpoint listed separately) Death
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List additional health endpoints (separately).
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List additional health endpoints (separately)
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Notes
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Clinical
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Physiological Physiological
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Other
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What is the study design? Case report
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Randomized or Non-Randomized?
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What were the diagnostics or methods used to measure the outcome? Objective
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Optional: Name of Method or short description
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Caffeine (general) Caffeine (general)
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Coffee
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Chocolate
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Energy drinks
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Gum
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Medicine/Supplement
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Soda
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Tea
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Measured Measured
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Self-report
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Children
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Adolescents
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Adults Adults
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Pregnant Women
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What was the reference, comparison, or control group(s)? (e.g. high vs low consumption, number of cups, etc.) NA - case report
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What were the listed confounders or modifying factors as stated by the authors? (e.g. multi-variable components of models.  Copy from methods) NA
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Provide a general description of results (as reported by the authors). Caffeine anhydrous is colorless when dissolved in water. Initial toxicological studies were negative for common drugs of abuse, but the presence of dried white powdery fluid within the decedent’s vehicle and on his shirt along with the presence of an opened bag of caffeine anhydrous (Fig. 5) prompted quantitative analysis for blood caffeine levels. Blood caffeine levels were measured as 350 mg/L. The opened bag of caffeine anhydrous was marked as containing 200 g of 100% pure compound. On weighing the residual bag contents, only 178 g of caffeine powder was present, indicating that approximately 22 g had been mixed for consumption. Given that 50 mL of watery fluid was present in the stomach and dried caffeine anhydrous solution was present in the vehicle and down the front of the decedent’s shirt, it was estimated that approximately 50% to 60% of the initial oral dose had been retained after ingestion, giving a dose of 10 to 12 g of caffeine.
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Did the authors perform a dose-response analysis (or trend/related analysis)? No
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What were the authors's observations re: trend analysis?
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What were the author's conclusions? As no other significant findings were made at autopsy, the cause of death in this case was attributed to fatal caffeine intoxication, with the manner of death designated as accidental.
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What were the sources of funding? NA
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What conflicts of interest were reported? The authors report no conflicts of interest.
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Does the exposure (dose) need to be standardized to the SR? No
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Provide calculations/conversions for the exposure based on the decision tree in the guide (for all endpoints/exposure levels of interest).
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List all the endpoint(s) followed by the dose (mg) which will be used in comparison to Nawrot.  Characterize value as LOAEL/NOAEL, etc. if possible.  Death LOAEL = 10-12 g
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Notes regarding selection/listing of endpoints and exposures/doses to be compared to Nawrot. The approximate 10-12 g ingestion was calculated from the "residual bag contents of 178 g caffeine powder, indicating approximated 22g had been mixed for consumption... It was estimated that approximately 50% to 60% of the initial oral dose had been retained after ingestion, giving a dose of 10 to 12 g of caffeine."
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What is the importance of the study with respect to the adverseness of the outcome? Critcal
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Baseline Characteristics
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Results & Comparisons

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Adverse Events
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