Quantifying the Effects of Prior Acetyl-Salicylic Acid on Sepsis-Related Deaths: An Individual Patient Data Meta-Analysis Using Propensity Matching

James Trauer, Stephen Muhi, Emma S. McBryde, Shmeylan A. Al Harbi, Yaseen M. Arabi, Andrew J. Boyle, Rodrigo Cartin-Ceba, Wei Chen, Yung-Tai Chen, Marco Falcone, Ognjen Gajic, Jack Godsell, Michelle Ng Gong, Daryl Kor, Wolfgang Lösche, Daniel F. McAuley, Hollis R. O'Neal, Michael Osthoff, Gordon P. Otto, Maik SossdorfMin Juei Tsai, Juan C. Valerio-Rojas, Tom van der Poll, Francesco Violi, Lorraine Ware, Andreas F. Widmer, Maryse A. Wiewel, Johannes Winning, Damon P. Eisen

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28 Citations (Scopus)


OBJECTIVE: The primary objective was to conduct a meta-analysis on published observational cohort data describing the association between acetyl-salicylic acid (aspirin) use prior to the onset of sepsis and mortality in hospitalized patients.

STUDY SELECTION: Studies that reported mortality in patients on aspirin with sepsis with a comparison group of patients with sepsis not on prior aspirin therapy were included.

DATA SOURCES: Fifteen studies described hospital-based cohorts (n = 17,065), whereas one was a large insurance-based database (n = 683,421). Individual-level patient data were incorporated from all selected studies.

DATA EXTRACTION: Propensity analyses with 1:1 propensity score matching at the study level were performed, using the most consistently available covariates judged to be associated with aspirin. Meta-analyses were performed to estimate the pooled average treatment effect of aspirin on sepsis-related mortality.

DATA SYNTHESIS: Use of aspirin was associated with a 7% (95% CI, 2-12%; p = 0.005) reduction in the risk of death as shown by meta-analysis with considerable statistical heterogeneity (I = 61.6%).

CONCLUSIONS: These results are consistent with effects ranging from a 2% to 12% reduction in mortality risk in patients taking aspirin prior to sepsis onset. This association anticipates results of definitive studies of the use of low-dose aspirin as a strategy for reduction of deaths in patients with sepsis.

Original languageEnglish
Pages (from-to)1871-1879
Number of pages9
JournalCritical Care Medicine
Issue number11
Publication statusPublished - 1 Nov 2017

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