Aspirin is Associated with Improved 30-day Mortality in Patients with Sepsis-associated Liver Injury: A retrospective Cohort Study Based on MIMIC IV Database

Wang, Jianbao; Hu, Xuemei; Cao, Susu; Zhao, Yiwen; Chen, Mengting; Hua, Tianfeng; Yang, Min

doi:10.3389/fphar.2025.1514392

ORIGINAL RESEARCH article

Front. Pharmacol.

Sec. Inflammation Pharmacology

Volume 16 - 2025 | doi: 10.3389/fphar.2025.1514392

This article is part of the Research Topic Infections in the Intensive Care Unit - Volume III View all articles

Aspirin is Associated with Improved 30-day Mortality in Patients with Sepsis-associated Liver Injury: A retrospective Cohort Study Based on MIMIC IV Database

Provisionally accepted

Jianbao Wang

Xuemei Hu

Susu Cao

Yiwen Zhao

Mengting Chen

Tianfeng Hua

Min Yang ^*

Anhui Medical University, Hefei, China

The final, formatted version of the article will be published soon.

Background: Sepsis-associated liver injury (SALI) is a common complication in sepsis patients, significantly affecting their prognosis. Previous studies have shown that aspirin can improve the prognosis of septic patients. However, there is currently a lack of clinical evidence supporting the use of aspirin in the treatment of SALI. Therefore, we conducted this study to explore the association between the use of aspirin and the prognosis of patients with SALI.The patients in this study were obtained from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, version 3.0. The primary outcome was 30day all-cause mortality. Baseline characteristics between the aspirin and non-aspirin groups were balanced using propensity score matching (PSM). The Kaplan-Meier survival curve and Cox regression analysis were used to investigate the association between aspirin use and the prognosis of patients with SALI.Results: Of 657 SALI patients in this study, 447 (68%) patients had not used aspirin during hospitalization, whereas 210 (32%) had. After PSM, the 30-day mortality was 33.1% in the non-aspirin group and 21% in the aspirin group, indicating a significantly reduced mortality risk in the aspirin group (HR, 0.57; 95% CI, 0.37-0.90; P = 0.016). Similarly, the results of the multivariable Cox regression analysis and inverse probability weighting (IPW) analysis showed that, compared to the non-aspirin group, the aspirin group had a significantly lower 30-day mortality risk (Multivariable Cox regression analysis: HR, 0.69; 95% CI, 0.48-0.99; P = 0.047; IPW: HR, 0.62; 95% CI, 0.43-0.89; P = 0.010).Aspirin can reduce 30-day mortality in SALI patients, regardless of the dose or timing of administration. However, careful assessment based on individual differences is essential to ensure the safety and effectiveness of aspirin use.

Keywords: Sepsis, Sepsis-associated liver injury, Aspirin, Platelet, Mortality

Received: 20 Oct 2024; Accepted: 14 Feb 2025.

Copyright: © 2025 Wang, Hu, Cao, Zhao, Chen, Hua and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Min Yang, Anhui Medical University, Hefei, China

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.