ORIGINAL RESEARCH article
Front. Pharmacol.
Sec. Drugs Outcomes Research and Policies
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1622440
This article is part of the Research TopicIncreasing Importance of Patients-generated Real World Data for Healthcare Policy Decisions about Medicinal Products: Volume IIIView all 6 articles
Early Acetaminophen Use and 90-Day Mortality in ICU Patients with Ischemic Stroke
Provisionally accepted
- 1Eastern Hepatobiliary Surgery Hospital affiliated to Naval Medical University, Shanghai, China
- 2Shanghai Changzheng Hospital affiliated to Naval Medical University, Shanghai, China
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Introduction: The impact of acetaminophen on the prognosis of ischemic stroke patients admitted to intensive care units remains unclear. Although acetaminophen is commonly used for fever and pain management, its potential benefits beyond temperature control require further investigation.Methods: Using the MIMIC-IV database, we retrospectively identified 494 ICU-admitted ischemic stroke patients, of whom 362 (73.28%) received early acetaminophen treatment within 48 hours after ICU admission. Patients were stratified based on acetaminophen exposure. Weighted Cox regression was applied after inverse probability of treatment weighting (IPTW) adjustment.Subgroup and sensitivity analyses were performed to assess the consistency of associations.Results: After IPTW adjustment, early acetaminophen use was associated with reduced 30-day mortality (HR 0.54, 95% CI 0.31-0.94, p = 0.030), and reduced 90-day mortality (HR 0.53, 95% CI 0.32-0.87, p = 0.013). There were no significant differences in in-hospital mortality or hospital length of stay. Subgroup analyses revealed no significant interaction effects, suggesting a consistent association across different clinical strata. Discussion: Early acetaminophen administrationacetaminophen use may be associated with improved survival outcomes in critically ill ischemic stroke patients. These findings highlight the potential therapeutic value of acetaminophen beyond symptomatic treatment, warranting confirmation through prospective, multicenter randomized controlled trials.
Keywords: Acetaminophen, ischemic stroke, Mortality, Inverse probability of treatment weighting, Intensive Care Units
Received: 03 May 2025; Accepted: 15 Jul 2025.
Copyright: © 2025 Piao, Zhang, Li, Jia and Cheng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Kun Cheng, Shanghai Changzheng Hospital affiliated to Naval Medical University, Shanghai, China
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