The primary objective was to conduct a meta-analysis on published observational cohort data describing the association between acetyl-salicylic acid
) use prior to the onset of sepsis
in hospitalized patients.
Studies that reported mortality
in patients on aspirin
with a comparison group of patients with sepsis
not on prior aspirin
therapy were included.
Fifteen studies described hospital-based cohorts (n
= 17,065), whereas one was a large insurance-based database (n
= 683,421). Individual-level patient data were incorporated from all selected studies.
Propensity analyses with 1:1 propensity score matching at the study level were performed, using the most consistently available covariates judged to be associated with aspirin
. Meta-analyses were performed to estimate the pooled average treatment effect of aspirin
Use of aspirin
was associated with a 7% (95% CI, 2–12%; p
= 0.005) reduction in the risk of death
as shown by meta-analysis with considerable statistical heterogeneity (I2
These results are consistent with effects ranging from a 2% to 12% reduction in mortality
risk in patients taking aspirin
prior to sepsis
onset. This association anticipates results of definitive studies of the use of low-dose aspirin
as a strategy for reduction of deaths in patients with sepsis