Choi Yu-Ri, Park Ji-In, An Seong-Sim, Choi Ji-Hye, Min Mi-Na, Kang Jin-Suk, Chung Jee-Eun
Department of Pharmacy, Seoul St. Mary's Hospital, Seoul, Korea.
College of Pharmacy and Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan, Gyeonggi-do, Korea.
Pharmacoepidemiol Drug Saf. 2025 Sep;34(9):e70210. doi: 10.1002/pds.70210.
Owing to their rapid antipyretic effects and predictable pharmacokinetic properties, acetaminophen (AAP) are commonly administered intravenously to severely ill patients. However, the potential development of hypotension as a consequence of intravenous AAP administration has not been thoroughly addressed. In this study, we aimed to identify the risk factors associated with the occurrence of serious hypotension following intravenous AAP administration during fever in patients with hematologic malignancies.
This retrospective study included hospitalized patients in the hemato-oncology department. Patients were evaluated for serious adverse drug reactions (ADRs) resulting from intravenous administration of AAP between January and December 2023 at a tertiary hospital. The control group comprised patients who received intravenous AAP but did not experience hypotension. After univariable analysis, multivariable analysis was performed to identify the risk factors for serious hypotension.
The serious hypotension group included 37 patients, while the control group had 111 patients randomized in a 1:3 ratio based on age and sex. Three risk factors were identified as increasing the likelihood of serious hypotension: body temperature prior to administration, acute kidney injury, and bacteremia. The mean arterial pressure prior to administration decreased the risk of developing serious hypotension by 0.96 times with an increase of 1 mmHg. There were no significant differences in the length of hospitalization or 90-day mortality between the two groups.
Given that patients with hematologic malignancies and associated risk factors may develop serious hypotension that can lead to death, it is essential to closely monitor blood pressure during intravenous administration of AAP.
由于对乙酰氨基酚（AAP）具有快速退热作用且药代动力学特性可预测，因此常用于对重症患者进行静脉给药。然而，静脉注射AAP导致低血压的潜在风险尚未得到充分研究。在本研究中，我们旨在确定血液系统恶性肿瘤患者发热时静脉注射AAP后发生严重低血压的相关危险因素。
这项回顾性研究纳入了血液肿瘤科的住院患者。对一家三级医院2023年1月至12月期间接受静脉注射AAP导致的严重药物不良反应（ADR）进行评估。对照组包括接受静脉注射AAP但未出现低血压的患者。在单变量分析之后，进行多变量分析以确定严重低血压的危险因素。
严重低血压组包括37例患者，对照组有111例患者，根据年龄和性别按1:3的比例随机分组。确定了三个增加严重低血压可能性的危险因素：给药前体温、急性肾损伤和菌血症。给药前平均动脉压每升高1 mmHg，发生严重低血压的风险降低0.96倍。两组患者的住院时间或90天死亡率无显著差异。
鉴于血液系统恶性肿瘤患者及相关危险因素可能会发生严重低血压并可能导致死亡，在静脉注射AAP期间密切监测血压至关重要。
