Department of Critical Care Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510006, Guangdong, China.
Anesthesiology Department, The Central Hospital of Shaoyang, Shaoyang, 422000, Hunan, China.
Pulm Pharmacol Ther. 2024 Jun;85:102288. doi: 10.1016/j.pupt.2024.102288. Epub 2024 Mar 8.
Acute Respiratory Distress Syndrome (ARDS) is a severe condition with high mortality and morbidity rates. Evidence on the effectiveness of pharmacological interventions for ARDS treatment is limited. Recent studies suggest that aspirin may prevent ARDS development, but its efficacy in established ARDS is uncertain.
We enrolled patients with ARDS using data from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database. Primary outcomes were 30- and 90-day mortality rates and length of ICU stay. We employed multivariable Cox regression and linear regression models for statistical analysis and used propensity score matching (PSM) to ensure robust results.
The study included 10,042 participants with an average age of 61.8 ± 15.3 years. Kaplan-Meier analysis showed significantly lower 30- and 90-day mortality rates in patients treated with pre-ICU admission aspirin compared with non-aspirin use (p < 0.0001). Multivariable Cox regression models revealed a significant 63% reduction in 30-day mortality for pre-ICU aspirin users (HR = 0.37, 95% CI: 0.31-0.44, p < 0.001). Aspirin use in the ICU was associated with a 59% reduction in ICU mortality and a 0.68-day reduction in length of ICU stay (p < 0.05). These findings consistently indicate that aspirin may improve survival in patients with ARDS, even after further stratification of aspirin use and PSM analysis.
Our findings suggest that aspirin treatment before ICU admission is associated with significantly reduced 30- and 90-day mortality rates and decreased length of ICU stay in patients with ARDS.
急性呼吸窘迫综合征（ARDS）是一种死亡率和发病率都很高的严重疾病。关于 ARDS 治疗的药物干预效果的证据有限。最近的研究表明，阿司匹林可能预防 ARDS 的发生，但在已确诊的 ARDS 中的疗效尚不确定。
我们使用来自医疗信息重症监护-IV（MIMIC-IV）数据库的数据招募了 ARDS 患者。主要结局是 30 天和 90 天的死亡率和 ICU 住院时间。我们使用多变量 Cox 回归和线性回归模型进行统计分析，并使用倾向评分匹配（PSM）来确保结果稳健。
该研究纳入了 10042 名平均年龄为 61.8±15.3 岁的患者。Kaplan-Meier 分析显示，与未使用阿司匹林的患者相比，在 ICU 前接受阿司匹林治疗的患者 30 天和 90 天的死亡率显著降低（p<0.0001）。多变量 Cox 回归模型显示，在 ICU 前使用阿司匹林的患者 30 天死亡率显著降低 63%（HR=0.37，95%CI：0.31-0.44，p<0.001）。在 ICU 中使用阿司匹林与 ICU 死亡率降低 59%和 ICU 住院时间缩短 0.68 天相关（p<0.05）。这些发现一致表明，阿司匹林治疗可能改善 ARDS 患者的生存率，即使在进一步分层阿司匹林使用和 PSM 分析后也是如此。
我们的研究结果表明，在 ARDS 患者 ICU 入院前使用阿司匹林与显著降低 30 天和 90 天死亡率以及 ICU 住院时间缩短相关。
