Aspirin cuts risk of death in critically ill patients with COPD

In critically ill patients with chronic obstructive pulmonary disease (COPD), aspirin use appears to improve survival, with reduced in-hospital mortality and fewer ICU readmission, according to a retrospective study.

Researchers used data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database and identified 3,184 critically ill adult patients with COPD. The primary outcome was 30-day mortality.

Of the patients, 1,074 (mean age 72.22 years, 56.2 percent male) were initiated on aspirin therapy within the first 24 h of ICU admission and 2,110 (mean age 71.67 years, 52.7 percent male) did not.

The primary outcome of 30-day mortality rate was lower among aspirin recipients than nonrecipients, at 13.0 percent vs 22.6 percent. Standardized mortality ratio weighting analysis showed a significant association between aspirin use and lower risk of 30-day mortality, with a risk reduction of 36 percent (hazard ratio [HR], 0.64, 95 percent confidence interval [CI], 0.52–0.77; p<0.001).

Compared with nonrecipients, aspirin recipients also had significantly reduced in-hospital mortality (odds ratio OR, 0.69, 95 percent CI, 0.50–0.96; p=0.029), longer duration without ICU readmission within 28 days (p=0.008), and prolonged time without mechanical ventilation within 28 days (p=0.004).

Sensitivity analyses yielded consistent results, with aspirin use remaining significantly associated with reduced 30-day mortality (HR, 0.72, 95 percent CI, 0.59–0.87; p=0.001).