Early acetaminophen administration is associated with lower mortality among ARDS patients after coronary artery bypass grafting: a retrospective study

Abstract Background Acetaminophen (APAP) is widely used in the treatment of patients after surgery, but the prognosis of patients with coronary artery bypass grafting (CABG)-related acute respiratory distress syndrome (CABG-ARDS) is still unclear. This study aims to explore the role of APAP in the m...

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Main Authors: Long Gui, Heshan Cao, Min Zheng, Yu Pan, Chengdong Ning, Mingjin Cheng
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Journal of Cardiothoracic Surgery
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Online Access:https://doi.org/10.1186/s13019-025-03421-x
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author Long Gui
Heshan Cao
Min Zheng
Yu Pan
Chengdong Ning
Mingjin Cheng
author_facet Long Gui
Heshan Cao
Min Zheng
Yu Pan
Chengdong Ning
Mingjin Cheng
author_sort Long Gui
collection DOAJ
description Abstract Background Acetaminophen (APAP) is widely used in the treatment of patients after surgery, but the prognosis of patients with coronary artery bypass grafting (CABG)-related acute respiratory distress syndrome (CABG-ARDS) is still unclear. This study aims to explore the role of APAP in the management of CABG related ARDS. Methods We collected clinical data on patients with CABG-ARDS from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database. The primary outcome was early mortality after ARDS, and the secondary outcomes were length of hospital stay and duration of mechanical ventilation (MV). Multivariate logistic regression and Cox regression models were used for statistical analysis, and inverse probability processing weighting (IPTW), overlap weighting (OW) and propensity score matching (PSM) were used to explore the robustness of the outcomes. Results A total of 5459 patients were enrolled in the analysis. Multivariate logistic regression analysis revealed that the 14-day mortality in APAP group was significantly lower than that in non-APAP group (0.5% vs. 2.7%, OR = 0.301; 95% CI, 0.170–0.531; P < 0.001). The APAP group also showed a significant advantage in Cox regression analysis (0.5% vs. 2.7%, HR = 0.329; 95% CI, 0.187–0.577; P < 0.001). IPTW, OW, and PSM analyses were conducted between the two groups, and the differences remained significant. These results were consistent in 30-, 60-, and 90-day mortality analyses. Meanwhile, exposure to APAP was associated with a shorter length of hospital stay and a reduced duration of MV (P < 0.001). Conclusion The administration of APAP was associated with reduced early mortality in patients with CABG-ARDS, as well as shorter length of hospital stay and duration of MV.
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spelling doaj-art-8ed891acdedf4be993966a072a14a7412025-08-20T02:17:52ZengBMCJournal of Cardiothoracic Surgery1749-80902025-04-0120111210.1186/s13019-025-03421-xEarly acetaminophen administration is associated with lower mortality among ARDS patients after coronary artery bypass grafting: a retrospective studyLong Gui0Heshan Cao1Min Zheng2Yu Pan3Chengdong Ning4Mingjin Cheng5Department of Cardiovascular Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen UniversityDepartment of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen UniversityDepartment of Cardiothoracic Surgery, Lu ’an Hospital Affiliated to Anhui Medical UniversityDepartment of Cardiothoracic Surgery, Lu ’an Hospital Affiliated to Anhui Medical UniversityDepartment of Cardiothoracic Surgery, Lu ’an Hospital Affiliated to Anhui Medical UniversityDepartment of Cardiothoracic Surgery, Lu ’an Hospital Affiliated to Anhui Medical UniversityAbstract Background Acetaminophen (APAP) is widely used in the treatment of patients after surgery, but the prognosis of patients with coronary artery bypass grafting (CABG)-related acute respiratory distress syndrome (CABG-ARDS) is still unclear. This study aims to explore the role of APAP in the management of CABG related ARDS. Methods We collected clinical data on patients with CABG-ARDS from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database. The primary outcome was early mortality after ARDS, and the secondary outcomes were length of hospital stay and duration of mechanical ventilation (MV). Multivariate logistic regression and Cox regression models were used for statistical analysis, and inverse probability processing weighting (IPTW), overlap weighting (OW) and propensity score matching (PSM) were used to explore the robustness of the outcomes. Results A total of 5459 patients were enrolled in the analysis. Multivariate logistic regression analysis revealed that the 14-day mortality in APAP group was significantly lower than that in non-APAP group (0.5% vs. 2.7%, OR = 0.301; 95% CI, 0.170–0.531; P < 0.001). The APAP group also showed a significant advantage in Cox regression analysis (0.5% vs. 2.7%, HR = 0.329; 95% CI, 0.187–0.577; P < 0.001). IPTW, OW, and PSM analyses were conducted between the two groups, and the differences remained significant. These results were consistent in 30-, 60-, and 90-day mortality analyses. Meanwhile, exposure to APAP was associated with a shorter length of hospital stay and a reduced duration of MV (P < 0.001). Conclusion The administration of APAP was associated with reduced early mortality in patients with CABG-ARDS, as well as shorter length of hospital stay and duration of MV.https://doi.org/10.1186/s13019-025-03421-xCoronary artery bypass graftingAcute respiratory distress syndromeAcetaminophenMIMIC-IVMortality
spellingShingle Long Gui
Heshan Cao
Min Zheng
Yu Pan
Chengdong Ning
Mingjin Cheng
Early acetaminophen administration is associated with lower mortality among ARDS patients after coronary artery bypass grafting: a retrospective study
Journal of Cardiothoracic Surgery
Coronary artery bypass grafting
Acute respiratory distress syndrome
Acetaminophen
MIMIC-IV
Mortality
title Early acetaminophen administration is associated with lower mortality among ARDS patients after coronary artery bypass grafting: a retrospective study
title_full Early acetaminophen administration is associated with lower mortality among ARDS patients after coronary artery bypass grafting: a retrospective study
title_fullStr Early acetaminophen administration is associated with lower mortality among ARDS patients after coronary artery bypass grafting: a retrospective study
title_full_unstemmed Early acetaminophen administration is associated with lower mortality among ARDS patients after coronary artery bypass grafting: a retrospective study
title_short Early acetaminophen administration is associated with lower mortality among ARDS patients after coronary artery bypass grafting: a retrospective study
title_sort early acetaminophen administration is associated with lower mortality among ards patients after coronary artery bypass grafting a retrospective study
topic Coronary artery bypass grafting
Acute respiratory distress syndrome
Acetaminophen
MIMIC-IV
Mortality
url https://doi.org/10.1186/s13019-025-03421-x
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