Abstract
Little is known about the effect of long-term aspirin use on acute severity of COPD. We hypothesized that, in patients hospitalized for acute exacerbation of COPD (AECOPD), long-term aspirin use is associated with lower risks of disease severity (in-hospital death, mechanical ventilation use, and hospital length-of-stay). We conducted a retrospective cohort study using large population-based data from 2012 through 2013. Among 206,686 patients (aged ≥40 years) hospitalized for AECOPD, aspirin users had lower in-hospital mortality (1.0 vs. 1.4%; OR 0.60 [95% CI 0.50–0.72]; P < 0.001) and lower risk of invasive mechanical ventilation use (1.7 vs. 2.6%; OR 0.64 [95% CI 0.55–0.73]; P < 0.001) compared to non-users, while there was no significant difference in risks of non-invasive positive pressure ventilation use. Length-of-stay was shorter in aspirin users compared to non-users (P < 0.001). In sum, in patients with AECOPD, aspirin use was associated with lower rates of in-hospital mortality and invasive mechanical ventilation use, and shorter length-of-stay.
Highlights
Increasing evidence suggests a potential benefit of antiplatelet therapy on chronic outcomes in patients with chronic obstructive pulmonary disease (COPD).[1,2]
Little is known about the effect of aspirin use on acute outcomes in patients hospitalized for acute exacerbation of COPD (AECOPD)
We identified all hospitalizations made by patients aged ≥40 years with a primary discharge diagnosis of COPD (ICD-9-CM codes: 491.21, 491.22, 491.8, 491.9, 492.8, 493.20, 493.21, 493.22, and 496), or those with a primary diagnosis of respiratory failure and a secondary diagnosis of COPD.[4]
Summary
The association of aspirin use with severity of acute exacerbation of chronic obstructive pulmonary disease: a retrospective cohort study. In patients hospitalized for acute exacerbation of COPD (AECOPD), long-term aspirin use is associated with lower risks of disease severity (in-hospital death, mechanical ventilation use, and hospital length-of-stay). In patients with AECOPD, aspirin use was associated with lower rates of in-hospital mortality and invasive mechanical ventilation use, and shorter length-of-stay. Increasing evidence suggests a potential benefit of antiplatelet therapy on chronic outcomes in patients with chronic obstructive pulmonary disease (COPD).[1,2] For example, a recent analysis of an ongoing prospective cohort study revealed that antiplatelet therapy was associated with a lower 1-year mortality among individuals with COPD.[1] little is known about the effect of aspirin use on acute outcomes (including mortality) in patients hospitalized for acute exacerbation of COPD (AECOPD). Consistent with our findings, previous cohort studies have reported that, among patients with COPD, the use of antiplatelet therapy is associated with a lower long-term mortality.[6]
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