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.

中文翻译：

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使用阿司匹林对炎症性肠病患者预后的影响：来自国家数据库的见解

背景

炎症性肠病（IBD）是一种炎症性疾病，会增加死亡风险。阿司匹林是一种抗炎药，用于心血管事件的一级预防。此前的一项单中心分析报告称，阿司匹林的使用不会影响 IBD 的主要结局。在这项研究中，我们旨在利用国家数据评估阿司匹林的使用对 IBD 患者死亡率和其他结果的影响。

方法

2016-2020 年全国住院患者样本 (NIS) 用于识别 IBD 成年患者。收集有关患者人口统计、医院特征和合并症的数据。研究的结果包括院内死亡率、败血症、休克、入住重症监护病房 (ICU) 以及手术需要。进行多变量逻辑回归分析。

结果

总共包括 1,524,820 例 IBD 住院患者。其中，137,430 人（9%）是长期服用阿司匹林的人。阿司匹林组的大多数患者年龄> 65岁（34.11％），女性（56.37％），白人（78.83％）并且有医疗保险（36.77％）。阿司匹林使用者的院内死亡率（1.6% vs 1.4%，P = 0.06）、败血症（2.5% vs 2.9%，P < 0.001）、休克（2.9% vs 3.4%，P < 0.001）、ICU 的发生率较低入院率（2.6% vs 2.9%，P < 0.001），需要手术（2.1% vs 4.2%，P < 0.001）。调整混杂因素后，阿司匹林与死亡率降低相关（调整后优势比：0.49，95%CI 0.45–0.55，P < 0.001）。

结论

我们的研究报告称，IBD 患者使用阿司匹林可降低死亡、败血症和休克的风险。使用阿司匹林可能对 IBD 患者具有保护作用。需要进一步的研究来证实这些结果。