Key result
Long-term aspirin use in hospitalized patients with inflammatory bowel disease was associated with reduced in-hospital mortality (adjusted OR 0.49, 95% CI 0.45-0.55, P<0.001).
Why the study?
Prior single-center data suggested aspirin did not impact major outcomes in IBD, prompting an assessment of its impact on mortality and clinical outcomes using national data.
Does long-term aspirin use reduce in-hospital mortality and other complications in hospitalized patients with inflammatory bowel disease?
Observational (n=1,524,820)
Yes
Does long-term aspirin use reduce in-hospital mortality and other complications in hospitalized patients with inflammatory bowel disease?
Odds Ratio: 0.49 (95% CI 0.45–0.55)
Absolute Event Rate: 1.5% vs 1.6%
p-value: p=<0.001
In hospitalized patients with inflammatory bowel disease, long-term aspirin use is associated with significantly lower in-hospital mortality, sepsis, and shock, though it increases the risk of acute kidney injury.
Hypothesis-generating for aspirin in IBD; leaves open causality and does not support practice change.
BACKGROUND: Inflammatory bowel disease (IBD) is an inflammatory disorder that can increase the risk of mortality. Aspirin is an anti-inflammatory drug used for primary prevention of cardiovascular events. A single center analysis previously reported that aspirin use did not impact major outcomes in IBD. In this study, we aim to assess the impact of aspirin use on mortality and other outcomes in patients with IBD using national data. METHODS: National inpatient sample (NIS) 2016-2020 was used to identify adult patients with IBD. Data were collected on patient demographics, hospital characteristics, and comorbidities. The outcomes studied were in-hospital mortality, sepsis, shock, Intensive Care Unit (ICU) admission, and need for surgery. Multivariate logistic regression analysis was performed. RESULTS: A total of 1,524,820 IBD hospitalizations were included. Of these, 137,430 (9%) were long-term aspirin users. The majority of the patients in the aspirin group were aged > 65 years (34.11%), female (56.37%), White (78.83%) and had Medicare insurance (36.77%). Aspirin users had a lower incidence of in-hospital mortality (1.6% vs 1.4%, P = 0.06), sepsis (2.5% vs 2.9%, P < 0.001), shock (2.9% vs 3.4%, P < 0.001), ICU admission (2.6% vs 2.9%, P < 0.001), need for surgery (2.1% vs 4.2%, P < 0.001). After adjusting for confounders, aspirin was associated with a reduction in mortality (adjusted odds ratio: 0.49, 95%CI 0.45-0.55, P < 0.001). CONCLUSION: Our study reports that aspirin use among patients with IBD was associated with a lower risk of death, sepsis, and shock. Aspirin use may have a protective effect in patients with IBD. Further studies are needed to confirm these results.
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Iqbal et al. (2023) conducted an observational in Inflammatory bowel disease (n=1,524,820). Long-term aspirin use vs. Non-aspirin use was evaluated on In-hospital mortality (aOR 0.49, 95% CI 0.45-0.55, p=<0.001). Long-term aspirin use in hospitalized patients with inflammatory bowel disease was associated with reduced in-hospital mortality (adjusted OR 0.49, 95% CI 0.45-0.55, P<0.001).
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