Quantifying the effects of prior acetyl-salicylic acid on sepsis-related deaths: An individual patient data meta-analysis using propensity matching

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

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

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 (I2 = 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
Volume45
Issue number11
DOIs
Publication statusPublished - 01 Nov 2017

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    Trauer , J., Muhi , S., Al Harbi, S. A., Arabi, Y. M., Boyle, A., Cartin-Ceba, R., Chen, W., Chen, Y-T., Falcone, M., Gajic, O., Godsell, J., Ng Gong, M., Kor, D., Lösche, W., McAuley, D., O'Neal Jr, H. R., Osthoff, M., Otto, G. P., Sossdorf, M., ... Eisen, D. P. (2017). Quantifying the effects of prior acetyl-salicylic acid on sepsis-related deaths: An individual patient data meta-analysis using propensity matching. Critical Care Medicine, 45(11), 1871-1879. https://doi.org/10.1097/CCM.0000000000002654