Aspirin tied to reduced risk of mortality, sepsis, and shock among IBD patients
Inflammatory bowel disease (IBD) is a chronic inflammatory disorder affecting the gastrointestinal tract, including Crohn’s disease (CD) and ulcerative colitis (UC). IBD affects over 1 million people in the US and is linked to increased short- and long-term mortality. CD and UC are influenced by microbial, genetic, immune, and environmental factors.
In a study published in the International Journal of Colorectal Disease, Humzah Iqbal et al. and colleagues found that aspirin usage in IBD patients is associated with a reduced risk of mortality, sepsis, and shock. Aspirin may offer protective effects in IBD patients.
IBD can increase the mortality risk. Aspirin is an anti-inflammatory drug used for primary prevention of cardiovascular events. However, the impact of aspirin use on significant outcomes in IBD remains unclear.
The NIS (National Inpatient Sample) 2016-2020 was used to identify adult IBD patients, with data collected on demographics, hospital characteristics, and comorbidities. The study analyzed in-hospital mortality, sepsis, shock, ICU admission, and surgery needs using multivariate logistic regression.
The study could be summarised as follows:
- The study included 1,524,820 IBD hospitalizations.
- 137,430 patients were long-term aspirin users.
- In the aspirin group, 34% of patients were aged > 65 years, 56% were female, 78% were White, and 36% had Medicare insurance.
- Aspirin users had a lower incidence of in-hospital mortality (1.6% vs 1.4%), sepsis (2.5% vs 2.9%), shock (2.9% vs 3.4%), ICU admission (2.6% vs 2.9%), and surgery need (2.1% vs 4.2%).
- After adjusting for confounders, aspirin was associated with a reduction in mortality having adjusted odds ratio of 0.49.
They said, Our study used an extensive NIS database to assess the outcomes of patients hospitalized with IBD taking aspirin. Previous literature has shown that White patients are more likely to be taking long-term aspirin even when controlling for cardiovascular risk factors. These findings suggest that the study sample is representative of the population taking aspirin. The study also found lower odds of surgical intervention in patients with long-term aspirin use, which may be due to the effect of aspirin on the disease activity among IBD patients. The incidence of surgical intervention in the study was 4%.
Reference:
Iqbal H et al. The impact of aspirin use on outcomes in patients with inflammatory bowel disease: Insights from a national database. Int J Colorectal Dis. 2023 Dec 20;39(1):6