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Association of acetaminophen use with mortality and renal recovery in patients with sepsis-associated acute kidney injury
Sepsis-associated acute kidney injury (SA-AKI) is common and associated with poor outcomes in critically ill patients. Acetaminophen is often used as an antipyretic and analgesic drug, but the association of acetaminophen use with mortality and recovery of renal function in SA-AKI patients remain un...
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Published in: | BMC anesthesiology 2024-11, Vol.24 (1), p.440-8 |
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description | Sepsis-associated acute kidney injury (SA-AKI) is common and associated with poor outcomes in critically ill patients. Acetaminophen is often used as an antipyretic and analgesic drug, but the association of acetaminophen use with mortality and recovery of renal function in SA-AKI patients remain unclear. We aimed to investigate the association between acetaminophen use and outcomes in SA-AKI patients.
This is a retrospective cohort study based on the MIMIC-IV database. Adult patients with SA-AKI were included in the analysis. The exposure was acetaminophen use within 7 days after the onset of SA-AKI. The primary outcome was 28-day mortality. Secondary outcomes included ICU mortality, in-hospital mortality, 90-day mortality, 1-year mortality, and renal recovery. Cox proportional hazards regression models were used to estimate the hazard ratio (HR) with 95% confidence interval (CI) for mortality. Logistic regression models were used to estimate the odd ratio (OR) with 95% CI for renal recovery.
6752 patients with SA-AKI were included, and 3892 (57.6%) patients received acetaminophen. Acetaminophen use was associated with decreased 28-day mortality (HR 0.69, 95% CI 0.63-0.75), ICU mortality (HR 0.56, 95% CI 0.50-0.63), in-hospital mortality (HR 0.62, 95% CI 0.57-0.69), 90-day mortality (HR 0.73, 95% CI 0.68-0.79), and 1-year mortality (HR 0.62, 95% CI 0.57-0.69). Acetaminophen use also was associated with improved renal recovery (OR 1.15, 95% CI 1.04-1.28).
Acetaminophen use is associated with decreased mortality and improved renal recovery in SA-AKI patients. |
doi_str_mv | 10.1186/s12871-024-02756-7 |
format | article |
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This is a retrospective cohort study based on the MIMIC-IV database. Adult patients with SA-AKI were included in the analysis. The exposure was acetaminophen use within 7 days after the onset of SA-AKI. The primary outcome was 28-day mortality. Secondary outcomes included ICU mortality, in-hospital mortality, 90-day mortality, 1-year mortality, and renal recovery. Cox proportional hazards regression models were used to estimate the hazard ratio (HR) with 95% confidence interval (CI) for mortality. Logistic regression models were used to estimate the odd ratio (OR) with 95% CI for renal recovery.
6752 patients with SA-AKI were included, and 3892 (57.6%) patients received acetaminophen. Acetaminophen use was associated with decreased 28-day mortality (HR 0.69, 95% CI 0.63-0.75), ICU mortality (HR 0.56, 95% CI 0.50-0.63), in-hospital mortality (HR 0.62, 95% CI 0.57-0.69), 90-day mortality (HR 0.73, 95% CI 0.68-0.79), and 1-year mortality (HR 0.62, 95% CI 0.57-0.69). Acetaminophen use also was associated with improved renal recovery (OR 1.15, 95% CI 1.04-1.28).
Acetaminophen use is associated with decreased mortality and improved renal recovery in SA-AKI patients.</description><identifier>ISSN: 1471-2253</identifier><identifier>EISSN: 1471-2253</identifier><identifier>DOI: 10.1186/s12871-024-02756-7</identifier><identifier>PMID: 39604841</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Acetaminophen ; Acetaminophen - therapeutic use ; Acute kidney injury ; Acute Kidney Injury - mortality ; Aged ; Analgesics ; Analgesics, Non-Narcotic - therapeutic use ; Analysis ; Body temperature ; Cohort analysis ; Cohort Studies ; Comorbidity ; Creatinine ; Female ; Hemoglobin ; Hospital Mortality ; Hospitals ; Humans ; Infection ; Intensive care ; Kidneys ; Leukocytes ; Male ; Middle Aged ; Mortality ; Patient outcomes ; Patients ; Recovery of Function ; Regression analysis ; Renal function ; Renal recovery ; Renal replacement therapy ; Retrospective Studies ; Sepsis ; Sepsis - complications ; Sepsis - drug therapy ; Sepsis - mortality ; Ventilators</subject><ispartof>BMC anesthesiology, 2024-11, Vol.24 (1), p.440-8</ispartof><rights>2024. The Author(s).</rights><rights>COPYRIGHT 2024 BioMed Central Ltd.</rights><rights>2024. This work is licensed under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2024 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11603937/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/3142295977?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,37013,44590,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39604841$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Li, Long-Zhu</creatorcontrib><creatorcontrib>Zhang, Lu-Ming</creatorcontrib><creatorcontrib>Ye, Yan</creatorcontrib><creatorcontrib>Su, Qing</creatorcontrib><creatorcontrib>Leong, Kan Fat</creatorcontrib><creatorcontrib>Yin, Hai-Yan</creatorcontrib><creatorcontrib>Gu, Wan-Jie</creatorcontrib><creatorcontrib>Ma, Min</creatorcontrib><title>Association of acetaminophen use with mortality and renal recovery in patients with sepsis-associated acute kidney injury</title><title>BMC anesthesiology</title><addtitle>BMC Anesthesiol</addtitle><description>Sepsis-associated acute kidney injury (SA-AKI) is common and associated with poor outcomes in critically ill patients. Acetaminophen is often used as an antipyretic and analgesic drug, but the association of acetaminophen use with mortality and recovery of renal function in SA-AKI patients remain unclear. We aimed to investigate the association between acetaminophen use and outcomes in SA-AKI patients.
This is a retrospective cohort study based on the MIMIC-IV database. Adult patients with SA-AKI were included in the analysis. The exposure was acetaminophen use within 7 days after the onset of SA-AKI. The primary outcome was 28-day mortality. Secondary outcomes included ICU mortality, in-hospital mortality, 90-day mortality, 1-year mortality, and renal recovery. Cox proportional hazards regression models were used to estimate the hazard ratio (HR) with 95% confidence interval (CI) for mortality. Logistic regression models were used to estimate the odd ratio (OR) with 95% CI for renal recovery.
6752 patients with SA-AKI were included, and 3892 (57.6%) patients received acetaminophen. Acetaminophen use was associated with decreased 28-day mortality (HR 0.69, 95% CI 0.63-0.75), ICU mortality (HR 0.56, 95% CI 0.50-0.63), in-hospital mortality (HR 0.62, 95% CI 0.57-0.69), 90-day mortality (HR 0.73, 95% CI 0.68-0.79), and 1-year mortality (HR 0.62, 95% CI 0.57-0.69). Acetaminophen use also was associated with improved renal recovery (OR 1.15, 95% CI 1.04-1.28).
Acetaminophen use is associated with decreased mortality and improved renal recovery in SA-AKI patients.</description><subject>Acetaminophen</subject><subject>Acetaminophen - therapeutic use</subject><subject>Acute kidney injury</subject><subject>Acute Kidney Injury - mortality</subject><subject>Aged</subject><subject>Analgesics</subject><subject>Analgesics, Non-Narcotic - therapeutic use</subject><subject>Analysis</subject><subject>Body temperature</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Comorbidity</subject><subject>Creatinine</subject><subject>Female</subject><subject>Hemoglobin</subject><subject>Hospital Mortality</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Infection</subject><subject>Intensive care</subject><subject>Kidneys</subject><subject>Leukocytes</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Recovery of Function</subject><subject>Regression analysis</subject><subject>Renal function</subject><subject>Renal recovery</subject><subject>Renal replacement therapy</subject><subject>Retrospective Studies</subject><subject>Sepsis</subject><subject>Sepsis - complications</subject><subject>Sepsis - drug therapy</subject><subject>Sepsis - mortality</subject><subject>Ventilators</subject><issn>1471-2253</issn><issn>1471-2253</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNptkkuP0zAURiMEYoaBP8ACRWLDJoPfdlaoGvEYaSQ2sI5u7JvWJbGLnQzqv8elBaYIRX7o-vjYn5WqeknJNaVGvc2UGU0bwkRpWqpGP6ouqSglxiR__GB-UT3LeUsI1Ybwp9UFbxURRtDLar_KOVoPs4-hjkMNFmeYfIi7DYZ6yVj_8POmnmKaYfTzvobg6oQBxtLbeI9pX_tQ74oAw5yPdMZd9rmBkxpd0S4z1t-8C3jgt0vaP6-eDDBmfHEar6qvH95_ufnU3H3-eHuzumucIGxuhl5K25JeS2EFBSsdM5aIHlsHTrcSkfUKB2oRqEJjeM8oMCl7NlDHnOZX1e3R6yJsu13yE6R9F8F3vwoxrTtIs7cjdqBVq3qkTlkQolXG9Fa2hllOtKIoi-vd0bVb-gmdLZETjGfS85XgN9063neUKsJbfrjNm5Mhxe8L5rmbfLY4jhAwLrnjlBdKE00K-vofdBuXVF7-QAnGWtlq_ZdaQ0ngwxDLwfYg7VaGGqK4kLxQ1_-hyudw8jYGHHypn2149TDpn4i__xz-E_Ycx1U</recordid><startdate>20241128</startdate><enddate>20241128</enddate><creator>Li, Long-Zhu</creator><creator>Zhang, Lu-Ming</creator><creator>Ye, Yan</creator><creator>Su, Qing</creator><creator>Leong, Kan Fat</creator><creator>Yin, Hai-Yan</creator><creator>Gu, Wan-Jie</creator><creator>Ma, Min</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><general>BMC</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20241128</creationdate><title>Association of acetaminophen use with mortality and renal recovery in patients with sepsis-associated acute kidney injury</title><author>Li, Long-Zhu ; Zhang, Lu-Ming ; Ye, Yan ; Su, Qing ; Leong, Kan Fat ; Yin, Hai-Yan ; Gu, Wan-Jie ; Ma, Min</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-d402t-fb55c90b754c41ac5d28c04be9dad795ee2b6ef1cea16e883b21a255b2f1d2d73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Acetaminophen</topic><topic>Acetaminophen - therapeutic use</topic><topic>Acute kidney injury</topic><topic>Acute Kidney Injury - mortality</topic><topic>Aged</topic><topic>Analgesics</topic><topic>Analgesics, Non-Narcotic - therapeutic use</topic><topic>Analysis</topic><topic>Body temperature</topic><topic>Cohort analysis</topic><topic>Cohort Studies</topic><topic>Comorbidity</topic><topic>Creatinine</topic><topic>Female</topic><topic>Hemoglobin</topic><topic>Hospital Mortality</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Infection</topic><topic>Intensive care</topic><topic>Kidneys</topic><topic>Leukocytes</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Recovery of Function</topic><topic>Regression analysis</topic><topic>Renal function</topic><topic>Renal recovery</topic><topic>Renal replacement therapy</topic><topic>Retrospective Studies</topic><topic>Sepsis</topic><topic>Sepsis - complications</topic><topic>Sepsis - drug therapy</topic><topic>Sepsis - mortality</topic><topic>Ventilators</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Li, Long-Zhu</creatorcontrib><creatorcontrib>Zhang, Lu-Ming</creatorcontrib><creatorcontrib>Ye, Yan</creatorcontrib><creatorcontrib>Su, Qing</creatorcontrib><creatorcontrib>Leong, Kan Fat</creatorcontrib><creatorcontrib>Yin, Hai-Yan</creatorcontrib><creatorcontrib>Gu, Wan-Jie</creatorcontrib><creatorcontrib>Ma, Min</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest_Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Publicly Available Content (ProQuest)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>Directory of Open Access Journals</collection><jtitle>BMC anesthesiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Li, Long-Zhu</au><au>Zhang, Lu-Ming</au><au>Ye, Yan</au><au>Su, Qing</au><au>Leong, Kan Fat</au><au>Yin, Hai-Yan</au><au>Gu, Wan-Jie</au><au>Ma, Min</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association of acetaminophen use with mortality and renal recovery in patients with sepsis-associated acute kidney injury</atitle><jtitle>BMC anesthesiology</jtitle><addtitle>BMC Anesthesiol</addtitle><date>2024-11-28</date><risdate>2024</risdate><volume>24</volume><issue>1</issue><spage>440</spage><epage>8</epage><pages>440-8</pages><issn>1471-2253</issn><eissn>1471-2253</eissn><abstract>Sepsis-associated acute kidney injury (SA-AKI) is common and associated with poor outcomes in critically ill patients. Acetaminophen is often used as an antipyretic and analgesic drug, but the association of acetaminophen use with mortality and recovery of renal function in SA-AKI patients remain unclear. We aimed to investigate the association between acetaminophen use and outcomes in SA-AKI patients.
This is a retrospective cohort study based on the MIMIC-IV database. Adult patients with SA-AKI were included in the analysis. The exposure was acetaminophen use within 7 days after the onset of SA-AKI. The primary outcome was 28-day mortality. Secondary outcomes included ICU mortality, in-hospital mortality, 90-day mortality, 1-year mortality, and renal recovery. Cox proportional hazards regression models were used to estimate the hazard ratio (HR) with 95% confidence interval (CI) for mortality. Logistic regression models were used to estimate the odd ratio (OR) with 95% CI for renal recovery.
6752 patients with SA-AKI were included, and 3892 (57.6%) patients received acetaminophen. Acetaminophen use was associated with decreased 28-day mortality (HR 0.69, 95% CI 0.63-0.75), ICU mortality (HR 0.56, 95% CI 0.50-0.63), in-hospital mortality (HR 0.62, 95% CI 0.57-0.69), 90-day mortality (HR 0.73, 95% CI 0.68-0.79), and 1-year mortality (HR 0.62, 95% CI 0.57-0.69). Acetaminophen use also was associated with improved renal recovery (OR 1.15, 95% CI 1.04-1.28).
Acetaminophen use is associated with decreased mortality and improved renal recovery in SA-AKI patients.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>39604841</pmid><doi>10.1186/s12871-024-02756-7</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Acetaminophen Acetaminophen - therapeutic use Acute kidney injury Acute Kidney Injury - mortality Aged Analgesics Analgesics, Non-Narcotic - therapeutic use Analysis Body temperature Cohort analysis Cohort Studies Comorbidity Creatinine Female Hemoglobin Hospital Mortality Hospitals Humans Infection Intensive care Kidneys Leukocytes Male Middle Aged Mortality Patient outcomes Patients Recovery of Function Regression analysis Renal function Renal recovery Renal replacement therapy Retrospective Studies Sepsis Sepsis - complications Sepsis - drug therapy Sepsis - mortality Ventilators |
title | Association of acetaminophen use with mortality and renal recovery in patients with sepsis-associated acute kidney injury |
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