Safety of parenteral ketorolac use for analgesia in geriatric emergency department patients.

Autor: Anderson GL; Department of Pharmacy, USA., Mattson AE; Department of Pharmacy, USA. Electronic address: mattson.alicia@mayo.edu., Brown CS; Department of Pharmacy, USA., Cabrera D; Department of Emergency Medicine, USA., Mara KC; Division of Biomedical Statistics and Informatics, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA., Bellolio MF; Department of Emergency Medicine, USA.
Jazyk: angličtina
Zdroj: The American journal of emergency medicine [Am J Emerg Med] 2020 Apr; Vol. 38 (4), pp. 727-730. Date of Electronic Publication: 2019 Jun 06.
DOI: 10.1016/j.ajem.2019.06.009
Abstrakt: Objective: To assess the safety of a single dose of parenteral ketorolac for analgesia management in geriatric emergency department (ED) patients.
Methods: This was a retrospective study of all administrations of parenteral ketorolac to adults ≥65 years of age and matched controls. The primary outcome was the occurrence of any of the following adverse events within 30 days of the ED visit: gastrointestinal bleeding, intracranial bleeding, acute decompensated heart failure, acute coronary syndrome, dialysis, transfusion, and death. The secondary outcome was the occurrence of an increase in serum creatinine of ≥1.5 times baseline within 7 and 30 days of the ED visit.
Results: There were 480 patients included in the final analysis, of which 120 received ketorolac (3: 1 matching). The primary outcome occurred in 14 of 360 patients who did not receive ketorolac and 2 of 120 ketorolac patients (3.9% vs 1.7%, p = 0.38; OR 2.39, 95% CI 0.54-10.66). There was no occurrence of dialysis or death in either group. The secondary outcome occurred in 1 of 13 and 1 of 23 ketorolac patients with both a baseline serum creatinine and a measure within 7 and 30 days, respectively, but did not occur in patients who did not receive ketorolac (7 days: 7.7% vs 0.0%, p = 0.29; 30 days: 4.4% vs 0.0%, p = 0.22).
Conclusion: The use of single doses of parenteral ketorolac for analgesia management was not associated with an increased incidence of adverse cardiovascular, gastrointestinal, or renal adverse outcomes in a select group of older adults.
Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest to disclose.
(Copyright © 2019 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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