Key result
Aspirin use within 24 hours of ICU admission was associated with reduced 30-day mortality in critically ill patients with COPD (13.0% vs 22.6%; HR 0.64; 95% CI 0.52-0.77; P<0.001).
Why the study?
The impact of aspirin on mortality in patients with COPD remains unclear, particularly among those who are critically ill.
Does aspirin therapy initiated within the first 24 h of ICU admission reduce 30-day mortality in critically ill adult patients diagnosed with COPD?
Cohort (n=3,184)
Does aspirin therapy initiated within the first 24 h of ICU admission reduce 30-day mortality in critically ill adult patients diagnosed with COPD?
Hazard Ratio: 0.64 (95% CI 0.52–0.77)
Absolute Event Rate: 13% vs 22.6%
p-value: p=< 0.001
In critically ill patients with COPD, early initiation of aspirin in the ICU is associated with significantly reduced 30-day and in-hospital mortality.
BACKGROUND: The impact of aspirin on mortality in patients with chronic obstructive pulmonary disease (COPD) remains unclear, particularly those who are critically ill. METHODS: This retrospective cohort study utilized data from the MIMIC-IV 3.1 database to investigate the correlation between aspirin use and 30-day mortality among critically ill adult patients diagnosed with COPD. Patients who initiated aspirin therapy within the first 24 h of intensive care unit (ICU) admission were included in the analysis. The primary outcome was 30-day mortality. Multivariable analysis, 1:1 propensity score matching, and standardized mortality ratio weighting (SMRW) were employed to adjust for confounding factors. RESULTS: A total of 3184 patients were included in the study. The 30-day mortality rate was 13.0 % in aspirin recipients (140/1074) compared to 22.6 % in non-recipients (476/2110). Analysis using SMRW demonstrated a significant association between aspirin use and reduced 30-day mortality (HR, 0.64; 95 % CI, 0.52-0.77; P < 0.001). Furthermore, aspirin use was associated with decreased in-hospital mortality (OR, 0.69; 95 % CI, 0.50-0.96; P = 0.029), a longer duration without ICU readmission within 28 days (β, 1.13; 95 % CI, 0.30-1.96; P = 0.008), and prolonged time without mechanical ventilation within 28 days (β, 1.27; 95 % CI, 0.41-2.14; P = 0.004). Sensitivity analyses on the complete dataset confirmed a significant association between aspirin use and reduced 30-day mortality, with a hazard ratio of 0.72 (95 % CI, 0.59-0.87; P = 0.001). CONCLUSIONS: Aspirin was associated with reduced mortality in critically ill patients with COPD. These findings warrant further prospective studies to confirm the observed benefits of aspirin use in this population.
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Huang et al. (2025) conducted a cohort in Chronic obstructive pulmonary disease (COPD) in critically ill patients (n=3,184). Aspirin vs. No aspirin was evaluated on 30-day mortality (HR 0.64, 95% CI 0.52-0.77, p=< 0.001). Aspirin use within 24 hours of ICU admission was associated with reduced 30-day mortality in critically ill patients with COPD (13.0% vs 22.6%; HR 0.64; 95% CI 0.52-0.77; P<0.001).
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