Acetaminophen and Stroke Risk in Diabetic Nursing Home Patients Interview with:
Philippe Girard, MD,

Gérontopôle de Toulouse, CHU Toulouse
Toulouse, France What is the background for this study?

Response: The idea for this study came about in 2016 when a systematic review assessing acetaminophen’s adverse event (AEs) profile came out with results suggesting increased mortality and morbidity (Paracetamol: not as safe as we thought? A systematic literature review of observational studies, PMID: 25732175).

Pr Yves Rolland had collected data from his IQUARE study (Improving the Quality of Care of Long-Stay Nursing Home Residents in France, PMID: 26782872) including all prescriptions from over 6000 nursing home residents and all their medical history over an 18 month follow-up period.

We thought it would be a good idea to assess the safety profile of acetaminophen on this geriatric population. What are the main findings? 

Response: Our statistical team really outdid themselves to calculate propensity scores for acetaminophen intake. What this means is that bias is considerably reduced and our findings are akin to those of a randomized controlled trial, the gold standard of clinical trials, meaning very trustworthy.

We ran 6 different statistical models, to really try our data and found there was no increase in mortality and no increase in myocardial infarction in our population. What we also found, which surprised all of us, was a threefold increase in strokes for diabetic subjects in our population. What should readers take away from your report?

Response: Our results are the first to find such a link between acetaminophen, stroke risk and diabetes in an older population.

Our subjects were very old, 86 on average, meaning many factors could still influence stroke risk despite our solid statistical analyses.

Still, as diabetes affects roughly 25% of seniors (prevalence found on in the USA alone, there is definitely cause for concern and at the least for more studies to be conducted before definite conclusions affecting medical practice come out. What recommendations do you have for future research as a result of this work?

Response: I think the geriatric population needs more focus in scientific studies. Demographics in developed countries show we are living longer and healthier lives. Aging means our body undergoes changes on the cellular level which affects the way drugs affect us. I think it is in everyones best interested if medicine is aligned with the people whose health is being cared for.


Girard, P. , Sourdet, S. , Cantet, C. , de Souto Barreto, P. and Rolland, Y. (2019), Acetaminophen Safety: Risk of Mortality and Cardiovascular Events in Nursing Home Residents, a Prospective Study. J Am Geriatr Soc. doi:10.1111/jgs.15861 

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Last Updated on April 6, 2019 by Marie Benz MD FAAD