Abstract
BackgroundRecent studies have shown that prior antiplatelet drug use could ameliorate the risk and mortality of acute respiratory distress syndrome (ARDS). However, the connection between prior acetylsalicylic acid (aspirin) use and the risk of ARDS is unknown. Our primary objective was to perform a meta-analysis on the currently available studies to assess the association between aspirin use prior to ARDS onset and ARDS incidence in at-risk patients.MethodsTwo investigators separately searched four research databases: MEDLINE, EMBASE, Cochrane Library, and Web of Science for relevant articles from the earliest available data through to July 14, 2019. In this paper, we performed a meta-analysis of the fixed effects model using the inverse variance-weighted average method to calculate the pooled odds ratios (ORs) and 95% confidence intervals (CIs). The primary outcome was risk of ARDS, and the secondary outcome was the hospital mortality of at-risk patients.ResultsThis article included seven studies altogether, enrolling 6,764 at-risk patients. Our meta-analysis revealed that, compared to non-aspirin use, prior aspirin use was linked with a significantly lower incidence of ARDS in at-risk patients (OR, 0.78; 95% CI, 0.64–0.96; P = 0.018) with low statistical heterogeneity (I 2 = 1.7%). Additionally, difference between prior aspirin use and non-aspirin use was not remarkable for hospital mortality in at-risk patients (OR, 0.88; 95% CI, 0.73–1.07; P = 0.204), and this analysis did not involve statistical heterogeneity (I 2 = 0%).ConclusionsThis article indicates an association between prior aspirin use and a lower incidence of ARDS in at-risk patients, suggesting that aspirin use could potentially lower the risk of ARDS, and the investigation of such an effect is an interesting area for future clinical studies.
Highlights
Acute respiratory distress syndrome (ARDS) is a clinical syndrome with high morbidity and mortality
The outcomes were the risk of ARDS/acute lung injury (ALI) and hospital mortality, and the data extracted from all eligible articles were the risk adjusted odds ratio (OR) and 95% confidence interval (CI)
Our metaanalysis demonstrates that prior aspirin use could improve the risk of ARDS incidence, but may not decrease hospital mortality in at-risk patients
Summary
Acute respiratory distress syndrome (ARDS) is a clinical syndrome with high morbidity and mortality. ARDS is described as an inflammatory syndrome characterized by inflammatory injuries to the lungs mediated by immune cells, such as neutrophils and macrophages (Abraham, 2003; Frank et al, 2006; Perkins et al, 2007). The inflammatory response in the lungs is not under control and would lead to alveolar and capillary endothelial barrier injury, increasing its permeability to fluid. Recent studies have shown that prior antiplatelet drug use could ameliorate the risk and mortality of acute respiratory distress syndrome (ARDS). The connection between prior acetylsalicylic acid (aspirin) use and the risk of ARDS is unknown. Our primary objective was to perform a meta-analysis on the currently available studies to assess the association between aspirin use prior to ARDS onset and ARDS incidence in at-risk patients
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