Al Harbi Shmeylan A, Tamim Hani M, Al-Dorzi Hasan M, Sadat Musharaf, Arabi Yaseen M
Pharmaceutical Care Department, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
Department of Internal Medicine, American University of Beirut-Medical Center, Beirut, Lebanon.
BMC Pharmacol Toxicol. 2016 Feb 5;17:5. doi: 10.1186/s40360-016-0047-z.
Antiplatelet therapy may attenuate the undesirable effects of platelets on the inflammatory cascades in critical illness. The objective of this study was to evaluate the association between aspirin therapy during intensive care unit (ICU) stay and all-cause mortality.
This was a nested cohort study within two randomized controlled trials in which all enrolled patients (N = 763) were grouped according to aspirin intake during ICU stay. The primary endpoints were all-cause ICU mortality and hospital mortality. Secondary endpoints included the development of severe sepsis during the ICU stay, ICU and hospital length of stay and the duration of mechanical ventilation. Propensity score was used to adjust for clinically and statistically relevant variables.
Of the 763 patients, 154 patients (20 %) received aspirin. Aspirin therapy was not associated with a reduction in ICU mortality (adjusted OR 1.18, 95 % CI 0.69-2.02, P = 0.55) nor with hospital mortality (adjusted OR 0.95, 95 % CI 0.61-1.50, P = 0.82). Aspirin use had no preferential association with mortality among any of the study subgroups. Additionally, aspirin therapy was associated with higher risk of ICU-acquired severe sepsis, and increased mechanical ventilation duration and ICU length of stay.
Our study showed that the use of aspirin in critically ill patients was not associated with lower mortality, but rather with an increased morbidity.
ISRCTN07413772 and ISRCTN96294863 .
抗血小板治疗可能会减轻血小板在危重症中对炎症级联反应产生的不良影响。本研究的目的是评估重症监护病房（ICU）住院期间使用阿司匹林治疗与全因死亡率之间的关联。
这是一项在两项随机对照试验中的巢式队列研究，所有纳入的患者（N = 763）根据ICU住院期间是否服用阿司匹林进行分组。主要终点是全因ICU死亡率和医院死亡率。次要终点包括ICU住院期间发生严重脓毒症、ICU和医院住院时间以及机械通气时间。使用倾向评分来调整临床和统计学上相关的变量。
763例患者中，154例（20%）接受了阿司匹林治疗。阿司匹林治疗与ICU死亡率降低无关（调整后的比值比为1.18，95%置信区间为0.69 - 2.02，P = 0.55），与医院死亡率也无关（调整后的比值比为0.95，95%置信区间为0.61 - 1.50，P = 0.82）。在任何研究亚组中，阿司匹林的使用与死亡率均无优先关联。此外，阿司匹林治疗与ICU获得性严重脓毒症的较高风险相关，且机械通气时间和ICU住院时间增加。
我们的研究表明，危重症患者使用阿司匹林与较低死亡率无关，反而与发病率增加有关。
ISRCTN07413772和ISRCTN96294863 。
