Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/12742
Full metadata record
DC FieldValueLanguage
dc.contributor.authorSuzuki, Satoshien
dc.contributor.authorEastwood, Glenn Men
dc.contributor.authorBailey, Michael Jen
dc.contributor.authorGattas, Daviden
dc.contributor.authorKruger, Peteren
dc.contributor.authorSaxena, Manojen
dc.contributor.authorSantamaria, John Den
dc.contributor.authorBellomo, Rinaldoen
dc.date.accessioned2015-05-16T02:28:30Z-
dc.date.available2015-05-16T02:28:30Z-
dc.date.issued2015-04-13en
dc.identifier.citationCritical Care 2015; 19(): 162en
dc.identifier.govdoc25879463en
dc.identifier.otherPUBMEDen
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/12742en
dc.description.abstractIn this study, we aimed to examine the association between paracetamol administration in the intensive care unit (ICU) and mortality in critically ill patients.We conducted a multicenter retrospective observational study in four ICUs. We obtained information on paracetamol use, body temperature, demographic, clinical and outcome data from each hospital's clinical information system and admissions and discharges database. We performed statistical analysis to assess the association between paracetamol administration and hospital mortality.We studied 15,818 patients with 691,348 temperature measurements at 4 ICUs. Of these patients, 10,046 (64%) received at least 1 g of paracetamol. Patients who received paracetamol had lower in-hospital mortality (10% vs. 20%, P <0.001), and survivors were more likely to have received paracetamol (66% vs. 46%; P <0.001). However, patients treated with paracetamol were also more likely to be admitted to the ICU after surgery (70% vs. 51%; P <0.001) and/or after elective surgery (55% vs. 37%; P <0.001). In multivariate logistic regression analysis including a propensity score for paracetamol treatment, we found a significant and independent association between the use of paracetamol and reduced in-hospital mortality (adjusted odds ratio =0.60 (95% confidence interval (CI), 0.53 to 0.68), P <0.001). Cox proportional hazards analysis showed that patients who received paracetamol also had a significantly longer time to death (adjusted hazard ratio =0.51 (95% CI, 0.46 to 0.56), P <0.001). The association between paracetamol and decreased mortality and/or time to death was broadly consistent across surgical and medical patients. It remained present after adjusting for paracetamol administration as a time-dependent variable. However, when such time-dependent analysis was performed, the association of paracetamol with outcome lost statistical significance in the presence of fever and suspected infection and in patients in the lower tertiles of Acute Physiology and Chronic Health Evaluation II scores.Paracetamol administration is common in the ICU and appears to be independently associated with reduced in-hospital mortality and time to death after adjustment for multiple potential confounders and propensity score. This association, however, was modified by the presence of fever, suspected infection and lesser illness severity and may represent the effect of indication bias.en
dc.language.isoenen
dc.titleParacetamol therapy and outcome of critically ill patients: a multicenter retrospective observational study.en
dc.typeJournal Articleen
dc.identifier.journaltitleCritical Careen
dc.identifier.affiliationAustin Health, Heidelberg, Victoria, Australiaen
dc.identifier.affiliationSt Vincent's Hospital, 59 Victoria Parade, Fitzroy, Victoria 3065, Australiaen
dc.identifier.affiliationPrincess Alexandra Hospital, 237 Ipswich Rd, Wooloongabba, QLD 4102, Australiaen
dc.identifier.affiliationRoyal Prince Alfred Hospital, Missenden Rd, Camperdown, NSW 2050, Australiaen
dc.identifier.affiliationAustralian and New Zealand Intensive Care Research Centre, Alfred Centre, 53 Commercial Rd, Melbourne, Victoria 3004, Australiaen
dc.identifier.affiliationSt George Hospital, Gray St, Kogarah, NSW 2217, Australiaen
dc.identifier.doi10.1186/s13054-015-0865-1en
dc.description.pages162en
dc.relation.urlhttps://pubmed.ncbi.nlm.nih.gov/25879463en
dc.type.austinJournal Articleen
local.name.researcherBellomo, Rinaldo
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.cerifentitytypePublications-
item.fulltextWith Fulltext-
item.grantfulltextopen-
item.languageiso639-1en-
item.openairetypeJournal Article-
crisitem.author.deptIntensive Care-
crisitem.author.deptIntensive Care-
crisitem.author.deptData Analytics Research and Evaluation (DARE) Centre-
Appears in Collections:Journal articles
Files in This Item:
File Description SizeFormat 
25879463.pdf952.32 kBAdobe PDFThumbnail
View/Open
Show simple item record

Page view(s)

20
checked on Mar 29, 2024

Download(s)

62
checked on Mar 29, 2024

Google ScholarTM

Check


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.