High-dose IV acetaminophen reduces delirium risk in older adults with acute abdominal conditions: a retrospective cohort study.

BACKGROUND

Delirium, a significant complication in older patients, often occurs during hospitalization and is associated with poor clinical outcomes. Effective strategies to prevent delirium are essential, particularly in emergency department (ED) settings where older patients frequently present with acute abdominal conditions. This study evaluated the impact of high-dose intravenous acetaminophen (≥ 1,000 mg) on the onset of delirium in older patients.

METHODS

This retrospective cohort study included 411 patients aged 70 years or older diagnosed with acute abdomen at the ED of Tosei General Hospital from October 2015 to December 2022. Patients were divided into high-dose (≥ 1,000 mg/administration) and low-dose (< 1,000 mg/administration) groups based on acetaminophen dosage. Multivariate logistic regression analysis was performed to adjust for confounding factors, including neurodegenerative diseases, sensory impairments, and serum albumin levels.

RESULTS

Of the 411 patients included in this study, 53 (12.9%) developed delirium during hospitalization, with the high-dose acetaminophen group demonstrating a significantly lower risk of delirium onset than that of the low-dose group (odds ratio: 0.391; 95% confidence interval: 0.193-0.791). Multivariate logistic regression analysis confirmed the protective effect of high-dose acetaminophen treatment after adjusting for potential confounding factors, suggesting this treatment protocol as a promising therapeutic approach for preventing delirium in older patients with acute abdominal conditions.

CONCLUSIONS

High-dose intravenous acetaminophen may effectively reduce the risk of delirium onset in older patients hospitalized with acute abdomen. These findings suggest a valuable role for high-dose acetaminophen in improving patient outcomes and reducing the burden of delirium in emergency and hospital care.

TRIAL REGISTRATION

Retrospectively registered.