Delirium Reduced With Intravenous Acetaminophen in Geriatric Hip Fracture Patients

The Journal of the American Academy of Orthopaedic Surgeons
Keith P ConnollySamir N Mehta

Abstract

Postoperative delirium is associated with opioid use in the elderly and is a common complication of geriatric hip fractures, with reported incidences from 16% to 70%. Intravenous (IV) acetaminophen is a safe and efficacious medication in elderly patients and has been shown to reduce use of opioids after hip fracture. At our institution, IV acetaminophen was implemented for the first 24 hours postoperatively as part of a multimodal pain control regimen for geriatric hip fracture patients. A retrospective review of 123 hip fragility fracture patients older than 60 years from January 2016 to December 2016 was performed. Delirium was identified using a validated chart-based review tool. The rate of delirium, as well as length of stay, pain scores, opioid administration, need for one-to-one supervision, and readmissions were analyzed. Sixty-five patients (52.8%) received IV acetaminophen during this period. No notable differences were found in baseline characteristics between groups. Ten of 65 patients receiving IV acetaminophen postoperatively experienced delirium compared with 19 of 58 who did not receive the medication (15.4% versus 32.8%, P = 0.024). The IV acetaminophen group also required fewer doses of IV opioids on postopera...Continue Reading

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Citations

Apr 29, 2020·Seminars in Cardiothoracic and Vascular Anesthesia·Liang ShenNatalia S Ivascu
Aug 10, 2020·Current Opinion in Anaesthesiology·Qiong YuYingwei Wang
Apr 17, 2020·Drugs & Aging·Gary EssesYury Khelemsky
Aug 28, 2021·JAAPA : Official Journal of the American Academy of Physician Assistants·Meagan L Barry, Kristopher R Maday

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