Evidence map›Paper›PMID 35534770›Full record

SynthesisCanadian journal of anaesthesia = Journal canadien d'anesthesie2022

Effect of intravenous acetaminophen on postoperative outcomes in hip fracture patients: a systematic review and narrative synthesis.

Jenny Sue Hyun Cho, Kristian McCarthy, Simone Schiavo, Binu Jacob, Marina Engelsakis, Michael Zywiel, Keyvan Karkouti, Stuart McCluskey, Hance Clarke, Jean Wong

Open access · bronzeAbstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
2.2field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Jenny Sue Hyun Cho *Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Kristian McCarthy *Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Simone SchiavoDepartment of Anesthesiology and Pain Management, University Health Network, University of Toronto, Toronto, ON, Canada.
Binu JacobDepartment of Anesthesiology and Pain Management, University Health Network, University of Toronto, Toronto, ON, Canada.
Marina EngelsakisGeneral Surgery, Anesthesia & Perioperative Care Education Investigator, The Institute of Education Research Library & Information Services, University Health Network, Toronto, ON, Canada.
Michael ZywielDivision of Orthopedic Surgery, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.
Keyvan KarkoutiDepartment of Anesthesiology and Pain Management, University Health Network, University of Toronto, Toronto, ON, Canada.
Stuart McCluskeyDepartment of Anesthesiology and Pain Management, University Health Network, University of Toronto, Toronto, ON, Canada.
Hance ClarkeDepartment of Anesthesiology and Pain Management, University Health Network, University of Toronto, Toronto, ON, Canada.
Jean WongDepartment of Anesthesiology and Pain Management, University Health Network, University of Toronto, Toronto, ON, Canada. jean.wong@uhn.ca.ORCID http://orcid.org/0000-0002-7213-4898
University Health Network · CAUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeHip fractures are debilitating in older adults because of their impact on quality of life. Opioids are associated with adverse effects in this population, so oral acetaminophen is commonly prescribed to minimize opioid use. Intravenous (iv) acetaminophen has been reported to have superior efficacy and bioavailability than oral acetaminophen. Nevertheless, its effect on postoperative outcomes in emergency hip fractures is unclear. This systematic review assessed the effect of iv acetaminophen on postoperative outcomes in older hip fracture patients. SOURCE: We searched multiple databases from inception to June 2021 for studies on adults > 50 yr of age undergoing emergency hip fracture surgery who received iv acetaminophen (or paracetamol) and that reported postoperative outcomes. Relevant titles, abstracts, and full texts were screened based on the eligibility criteria. The Newcastle-Ottawa scale was used to assess the quality of the selected papers. PRINCIPAL

findingsOf 3,510 initial studies, four met the inclusion criteria. One was a prospective cohort study and three were retrospective cohort studies. All four studies used historical control groups. Three studies reported a significantly lower mean opioid dose with iv acetaminophen than with oral acetaminophen. Three studies also reported a significantly shorter hospital stay. One study each reported a significant decrease in the number of missed physical therapy sessions, the need for one-to-one supervision, and episodes of delirium.

conclusionThere is very limited low-level evidence that iv acetaminophen improves preoperative and postoperative analgesia and shortens hospital stay in older hip fracture patients. Nevertheless, our results should be interpreted with caution since there are no prospective randomized trials investigating whether iv acetaminophen improves postoperative outcomes in this patient population. STUDY REGISTRATION: PROSPERO (CRD42021198174); registered 15 August 2021.

Indexed as

Analgesics, Non-NarcoticHip FracturesAcetaminophenAgedAnalgesics, OpioidHumansPostoperative PainProspective StudiesQuality of LifeRetrospective StudiesAcetaminophenAnalgesics, Non-NarcoticAnalgesics, Opioidacetaminophenelderlyhip fracturepainpostoperative

Identifiers

PMID35534770
OpenAlexW4229451807

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.