Saito Masayuki, Nishiwaki Nanaha, Nakashima Yoshihito, Hori Eisei, Suzuki Tadashi, Tachi Tomoya, Ichihara Toshihiko
Department of Pharmacy, Tosei General Hospital, 160 Nishi-Oiwake-Cho, Seto, Aichi, 489-8642, Japan.
Department of Clinical Pharmacy, Graduate School of Pharmaceutical Sciences, Nagoya City University, 3-1 Tanabe-Dori, Mizuho-Ku, Nagoya, 467-8603, Japan.
J Pharm Health Care Sci. 2025 Jul 1;11(1):56. doi: 10.1186/s40780-025-00462-1.
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.
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.
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.
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.
Retrospectively registered.
谵妄是老年患者的一种重要并发症，常在住院期间发生，且与不良临床结局相关。有效的谵妄预防策略至关重要，尤其是在急诊科（ED），老年患者常因急性腹部疾病前来就诊。本研究评估了高剂量静脉注射对乙酰氨基酚（≥1000毫克）对老年患者谵妄发作的影响。
这项回顾性队列研究纳入了2015年10月至2022年12月在东海综合医院急诊科诊断为急腹症的411例70岁及以上患者。根据对乙酰氨基酚剂量将患者分为高剂量（≥1000毫克/次给药）和低剂量（<1000毫克/次给药）组。进行多因素逻辑回归分析以调整混杂因素，包括神经退行性疾病、感觉障碍和血清白蛋白水平。
本研究纳入的411例患者中，53例（12.9%）在住院期间发生谵妄，高剂量对乙酰氨基酚组谵妄发作风险显著低于低剂量组（比值比：0.391；95%置信区间：0.193 - 0.791）。多因素逻辑回归分析在调整潜在混杂因素后证实了高剂量对乙酰氨基酚治疗的保护作用，表明该治疗方案是预防老年急腹症患者谵妄的一种有前景的治疗方法。
高剂量静脉注射对乙酰氨基酚可能有效降低老年急腹症住院患者谵妄发作的风险。这些发现表明高剂量对乙酰氨基酚在改善患者结局和减轻急诊及住院护理中谵妄负担方面具有重要作用。
回顾性注册。
