Retrospective analysis: Acetaminophen effects in critically ill gout and hypertension patients

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Created On: 12/12/2024

Acetaminophen is commonly used, but its effects in patients with gout and hypertension are unclear. This cohort study retrospectively examined how the use of Acetaminophen relates to the clinical outcomes of critically ill patients with these preexisting conditions, using real-world data.

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Key take away

Acetaminophen (non-opioid analgesic and antipyretic) has the potential to be an effective therapeutic option in managing critically ill patients with gout and hypertension, suggesting it may improve survival rates during acute care and warrant consideration in treatment protocols.

Background

Method

The Medical Information Mart in Intensive Care-IV (MIMIC-IV) database analyzed critically ill adults with hyperuricemia and hypertension. Acetaminophen use during intensive care unit stays was the primary exposure, with in-hospital mortality as the main outcome. Secondary outcomes included frequent hospitalization, 30- and 60-day all-cause mortality, and emergencies due to hypertension. Propensity score matching (1:1) and multivariable analyses were conducted to control for confounders.

Result

The pre-matched cohort comprised 2,448 patients, while the propensity score-matched (PSM) cohort included 1,012 patients. In the PSM analysis, in-hospital mortality was 9.7% (49 out of 506) for the Acetaminophen group compared to 12.1% (61 out of 506) for those not using the medication. Acetaminophen was related to a lowered risk of mortality during hospitalization. For secondary outcomes, no significant differences were found in 30-day and 60-day all-cause mortality between the groups post-PSM.

Analysis of dosage revealed that Acetaminophen use within a range of 2-4 g for 3-5 days suggestively reduced mortality in both the overall and PSM cohorts. As per the subgroup analysis, consistently lower in-hospital mortality across various baseline characteristics (age, gender, body-mass index, liver disease, and renal disease) without any significant interactions (interaction p-values > 0.05) was observed, strengthening the robustness of the findings.

Conclusion

A reduction in in-hospital mortality was associated with the use of Acetaminophen among critically ill patients suffering from gout and hypertension. To confirm these results, further prospective studies are warranted.