Association between oxycodone–acetaminophen use and acute kidney injury in patients with lower extremity fractures: A retrospective cohort study

Mortality rates in individuals suffering from acute kidney injury (AKI) are notably high. The association between the administration of oxycodone-acetaminophen and the onset of AKI remains elusive. We explored the connection between the use of oxycodone-acetaminophen and the development of AKI among hospitalized patients with fractures in the lower limbs. We employed the Critical Care Medical Information Mart (Simulation) IV database and studied the occurrence of AKI in individuals with fractures of the lower extremities. Information on the administration of oxycodone and acetaminophen during the 48 hours following hospitalization was collected. The logistic regression approach was used to analyze the outcomes between the 2 groups, with several models adjusted simultaneously. The reliability of the results was evaluated by conducting both stratified and sensitivity analyses. We conducted a retrospective cohort study involving 2801 patients with lower extremity fractures, including 339 oxycodone-acetaminophen users and 2462 non-users. The overall rate of AKI was 65.6% (1844/2801). The rate for non-users was 64.6% (1591/2462), whereas it was 74.6% (253/339) for non-users. After controlling for confounding variables, the use of oxycodone-acetaminophen was linked to a 38% increased risk of AKI (hazard ratio = 1.38, 95% confidence interval = 1.02-1.87, P < .038). Subgroup analyses revealed similar patterns of association, with all interaction P-values >.05. The use of oxycodone-acetaminophen within 48 hours of hospitalization may increase the risk of AKI in patients with lower extremity fractures. However, further randomized controlled trials are needed to elucidate this relationship.