Journal Article

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

Anderson, Gabrielle L., Brown, Caitlin S., Bellolio, M. Fernanda, Mattson, Alicia E., Mara, Kristin C., Cabrera, Daniel

2020

Overview

To assess the safety of a single dose of parenteral ketorolac for analgesia management in geriatric emergency department (ED) patients. 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. 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). 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.

• Publisher: Elsevier Inc,Elsevier Limited
• Subject: Acute coronary syndromes / Age / Analgesia / Anticoagulants / Bleeding / Cardiovascular disease / Congestive heart failure / Creatinine / Dialysis / Drug dosages / Drug-related side effects and adverse reactions / Emergency / Emergency medical care / Emergency service, hospital / Geriatrics / Health risk assessment / Heart failure / Ketorolac / Kidney diseases / Medical records / Narcotics / Nervous system / Older people / Pain management / Pain perception / Patient safety / Patients / Ulcers