Aspirin Use Associated With Reduced Mortality After ICU Stay

Use of aspirin can help decrease risk of 28-day mortality following admission to the intensive care unit.

According to results published in Clinical Therapeutics, investigators in China have found that aspirin use is associated with greater 28-day survival rates among intensive care unit (ICU) patients.

Retrospective data was collected from Medical Information Mart for Intensive Care (MIMIC)-III database and the eICU–Collaborative Research Database (CRD). In total, the study included 146,191 individuals, 27,424 (18.8%) of whom were given aspirin.

All individuals in the study were aged between 18 to 90 years, admitted to the ICU, and were not pregnant. Individuals who received nonaspirin antiplatelet drugs or only used aspirin outside of the ICU were excluded.

After extracting a broad range of health conditions as variables, investigators used multivariate Cox models and propensity score analysis to estimate the association of aspirin treatment with 28-day mortality. The investigators found that Kaplan-Meier survival curves showed a greater 28-day survival among those given aspirin treatment compared with the group that did not receive aspirin treatment.

. . . aspirin treatment in ICU patients, particularly those with SIRS symptoms and those without sepsis, led to lower 28-day all-cause mortality.

In the dataset from the eICU-CRD, the survival rate was 95.55% vs 93.88%. In the dataset from the MIMIC-III, the survival rate was 72.33% vs 59.91%.

The findings were consistent across multiple Cox regression models. The 28-day mortality was lower with aspirin treatment in the dataset from eICU-CRD (adjusted hazard ratio [aHR], 0.81; 95% CI, 0.75-0.87). Mortality was also lower in the dataset from MIMIC-III (aHR, 0.72; 95% CI, 0.68-0.76).

After applying a propensity matching score, researchers learned that the 28-day mortality was lower with aspirin treatment. Results were consistent from the dataset from eICU-CRD (HR, 0.80; 95% CI, 0.72-0.88) and the dataset from MIMIC-III (HR, 0.80; 95% CI, 0.76-0.85).

Study limitation include it being a retrospective analysis where not all participant characteristics are recorded. There is also no record of the rationale for administering aspirin to participants. The investigators recommend future randomized controlled trials to further study the effects of aspirin in ICU patients.

“…aspirin treatment in ICU patients, particularly those with SIRS symptoms and those without sepsis, led to lower 28-day all-cause mortality,” study authors wrote.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

This article originally appeared on The Cardiology Advisor


Wang L, Li B, Zuo L, et al. Aspirin therapy and 28-day mortality in ICU patients: a retrospective observational study from 2 large databases. Clin Ther. Published online March 25, 2023. doi:10.1016/j.clinthera.2023.02.005