University of Alabama School of Medicine, Birmingham, Alabama, United States of America.
Department of Emergency Medicine, University of Alabama School of Medicine, Birmingham, Alabama, United States of America.
PLoS One. 2018 Apr 18;13(4):e0194829. doi: 10.1371/journal.pone.0194829. eCollection 2018.
Sepsis is the syndrome of life-threatening organ dysfunction resulting from dysregulated host response to infection. Aspirin, an anti-inflammatory agent, may play a role in attenuating the inflammatory response during infection. We evaluated the association between aspirin use and long-term rates of sepsis as well as sepsis outcomes.
We analyzed data from 30,239 adults ≥45 years old in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. The primary exposure was aspirin use, identified via patient interview. The primary outcome was sepsis hospitalization, defined as admission for infection with two or more systemic inflammatory response syndrome criteria. We fit Cox proportional hazards models assessing the association between aspirin use and rates of sepsis, adjusted for participant demographics, health behaviors, chronic medical conditions, medication adherence, and biomarkers. We used a propensity-matched analysis and a series of sensitivity analyses to assess the robustness of our results. We also examined risk of organ dysfunction and hospital mortality during hospitalization for sepsis.
Among 29,690 REGARDS participants with follow-up data available, 43% reported aspirin use (n = 12,869). Aspirin users had higher sepsis rates (hazard ratio 1.35; 95% CI: 1.22-1.49) but this association was attenuated following adjustment for potential confounders (adjusted HR 0.99; 95% CI: 0.88-1.12). We obtained similar results in propensity-matched and sensitivity analyses. Among sepsis hospitalizations, aspirin use was not associated with organ dysfunction or hospital death.
In the REGARDS cohort, baseline aspirin use was not associated with long-term rates of sepsis.
脓毒症是一种危及生命的器官功能障碍综合征，由宿主对感染的失调反应引起。阿司匹林是一种抗炎药物，可能在减轻感染期间的炎症反应中发挥作用。我们评估了阿司匹林使用与长期脓毒症发生率以及脓毒症结局之间的关系。
我们分析了 Reasons for Geographic and Racial Differences in Stroke（REGARDS）队列中 30239 名年龄≥45 岁的成年人的数据。主要暴露因素是通过患者访谈确定的阿司匹林使用情况。主要结局是脓毒症住院，定义为因感染而住院，且符合两个或更多全身炎症反应综合征标准。我们拟合了 Cox 比例风险模型，评估了阿司匹林使用与脓毒症发生率之间的关系，调整了参与者的人口统计学、健康行为、慢性疾病、药物依从性和生物标志物。我们使用倾向匹配分析和一系列敏感性分析来评估我们结果的稳健性。我们还检查了脓毒症住院期间器官功能障碍和医院死亡率的风险。
在有随访数据的 29690 名 REGARDS 参与者中，43%（n=12869）报告使用了阿司匹林。阿司匹林使用者的脓毒症发生率较高（风险比 1.35；95%CI：1.22-1.49），但在调整潜在混杂因素后，这种相关性减弱（调整后的 HR 0.99；95%CI：0.88-1.12）。我们在倾向匹配和敏感性分析中得到了类似的结果。在脓毒症住院患者中，阿司匹林使用与器官功能障碍或医院死亡无关。
在 REGARDS 队列中，基线阿司匹林使用与长期脓毒症发生率无关。
