Long-Zhu Li, Lu-Ming Zhang, Yan Ye, Qing Su, Kan Fat Leong, Hai-Yan Yin, Wan-Jie Gu, Min Ma
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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.</p><p><strong>Results: </strong>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). 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引用次数: 0
摘要
背景：脓毒症相关急性肾损伤（SA-AKI）在重症患者中很常见，并与不良预后有关。对乙酰氨基酚常被用作解热镇痛药，但对乙酰氨基酚的使用与SA-AKI患者死亡率和肾功能恢复的关系仍不清楚。我们旨在研究对乙酰氨基酚的使用与 SA-AKI 患者预后之间的关系：这是一项基于 MIMIC-IV 数据库的回顾性队列研究。方法：这是一项基于 MIMIC-IV 数据库的回顾性队列研究。研究对象为 SA-AKI 发病后 7 天内使用对乙酰氨基酚的患者。主要结果是 28 天死亡率。次要结果包括重症监护室死亡率、院内死亡率、90 天死亡率、1 年死亡率和肾功能恢复情况。Cox比例危险回归模型用于估计死亡率的危险比（HR）及95%置信区间（CI）。逻辑回归模型用于估算肾功能恢复的奇数比（OR）及95%置信区间：结果：共纳入 6752 例 SA-AKI 患者，其中 3892 例（57.6%）患者接受了对乙酰氨基酚治疗。使用对乙酰氨基酚可降低 28 天死亡率（HR 0.69，95% CI 0.63-0.75）、ICU 死亡率（HR 0.56，95% CI 0.50-0.63）、院内死亡率（HR 0.62，95% CI 0.57-0.69）、90 天死亡率（HR 0.73，95% CI 0.68-0.79）和 1 年死亡率（HR 0.62，95% CI 0.57-0.69）。对乙酰氨基酚的使用还与肾功能恢复的改善有关（OR 1.15，95% CI 1.04-1.28）：对乙酰氨基酚的使用与SA-AKI患者死亡率的降低和肾功能恢复的改善有关。
Association of acetaminophen use with mortality and renal recovery in patients with sepsis-associated acute kidney injury.
Background: 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.
Methods: 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.
Results: 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).
Conclusions: Acetaminophen use is associated with decreased mortality and improved renal recovery in SA-AKI patients.
期刊介绍：
BMC Anesthesiology is an open access, peer-reviewed journal that considers articles on all aspects of anesthesiology, critical care, perioperative care and pain management, including clinical and experimental research into anesthetic mechanisms, administration and efficacy, technology and monitoring, and associated economic issues.
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