Evidence map›Paper›PMID 40134452›Full record

ArticleCHEST critical care2025

Acetaminophen and Clinical Outcomes in Sepsis: A Retrospective Propensity Score Analysis of the Ibuprofen in Sepsis Study.

Sarah N Obeidalla, Gordon R Bernard, Lorraine B Ware, V Eric Kerchberger

Abstract read
In one paragraph

Article in CHEST critical care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Sarah N ObeidallaDepartment of Medicine (S. N. O., G. R. B., L. B. W., and V. E. K.), the Department of Pathology, Microbiology and Immunology (L. B. W.), and the Department of Biomedical Informatics (V. E. K.), Vanderbilt University Medical Center, Nashville, TN.
Gordon R BernardDepartment of Medicine (S. N. O., G. R. B., L. B. W., and V. E. K.), the Department of Pathology, Microbiology and Immunology (L. B. W.), and the Department of Biomedical Informatics (V. E. K.), Vanderbilt University Medical Center, Nashville, TN.
Lorraine B WareDepartment of Medicine (S. N. O., G. R. B., L. B. W., and V. E. K.), the Department of Pathology, Microbiology and Immunology (L. B. W.), and the Department of Biomedical Informatics (V. E. K.), Vanderbilt University Medical Center, Nashville, TN.
V Eric KerchbergerDepartment of Medicine (S. N. O., G. R. B., L. B. W., and V. E. K.), the Department of Pathology, Microbiology and Immunology (L. B. W.), and the Department of Biomedical Informatics (V. E. K.), Vanderbilt University Medical Center, Nashville, TN.

Funding

Haptoglobin 2 variant and endothelial glycocalyx shedding in sepsis-induced ARDSR01HL158906 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI WARE, LORRAINE B · 2021 to 2024
$2.3M
Mechanisms of organ dysfunction and recovery in the Acetaminophen and Ascorbate Trial in SepsisR01HL164937 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI WARE, LORRAINE B · 2022 to 2025
$1.7M
Tissue-specific functional genomics in the acute respiratory distress syndromeK01HL157755 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI KERCHBERGER, VERN ERIC · 2021 to 2025
$845k
NHLBI NIH HHS K01 HL157755NHLBI NIH HHS R01 HL158906NHLBI NIH HHS R01 HL164937
6 · The paper itself

Abstract

backgroundThe Ibuprofen in Sepsis Study (ISS) randomized trial found no difference in duration of shock, ARDS, or mortality with ibuprofen treatment for sepsis. However, higher use of acetaminophen, a known hemoprotein reductant with potentially beneficial effects in sepsis, as an antipyretic in the control arm may have masked the clinical benefits from either drug. RESEARCH QUESTION: Does an association exist between administration of acetaminophen and clinical outcomes in adults with sepsis? STUDY DESIGN AND

methodsWe performed a retrospective propensity-matched analysis of the previously reported ISS trial. We created a propensity score for receiving acetaminophen during the first 2 study days using sex, age, presence of shock at enrollment, trial study drug assignment (ibuprofen or placebo), febrile status at enrollment, need for mechanical ventilation, and Acute Physiology and Chronic Health Evaluation II score at enrollment, and then matched trial participants 1:1 into acetaminophen-exposed and acetaminophen-unexposed groups based on their propensity scores. We tested the association between receipt of acetaminophen with 30-day mortality as the primary outcome. Secondary outcomes included development of renal failure and ventilator-free days (VFDs).

resultsOf 455 patients in the original trial, 276 patients (61%) were matched into acetaminophen-exposed and acetaminophen-unexposed groups. In the propensity-matched analysis, we found a lower mortality among acetaminophen-exposed patients compared with acetaminophen-unexposed patients (hazard ratio, 0.58; 95% CI, 0.40-0.84;

interpretationIn this propensity-matched retrospective analysis, adults with sepsis who received acetaminophen showed decreased mortality and more days alive and free of mechanical ventilation. This study highlights the potential of acetaminophen as a modulator of outcomes in sepsis and warrants further investigation.

Indexed as

acetaminophenmortalityobservational studypropensity scoressepsis/therapy

Identifiers

PMID40134452
PMCPMC11936508

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.