The Effect Of Aspirin Of Mortality Of Sepsis And Acute Respiratory Distress Syndrome: A Meta-analysis

Background and objective:The main parts of pathophysiology of Sepsis and acute respiratory distress syndrome（ARDS）is excessive inflammatory response and coagulation dysfunction,and platelets are involved in both of two parts of the progress and play an important role in the development of sepsis and ARDS.Previous preclinical studies have shown that aspirin can improve the prognosis of sepsis and ARDS,but the effect of aspirin on the mortality outcome of sepsis and ARDS has been controversial in clinical studies for a long time.Therefore,we conducted a meta-analysis evaluation method to assess the effect of aspirin on the mortality of sepsis and ARDS,in order to provide some useful reference for the future clinical medical work.Methods:Searching in Pub Med,Embase,The Cochrane Library,Web of Science,CBM,CNKI,and Wanfang database in the computer,and collect the relevant clinical studies on the effect of aspirin on sepsis and ARDS mortality between the establishment of the database and December 2021.Three researchers independently screened literatures to extract data and evaluated the risk of bias in the included studies,use the software Stata 14.0 for meta-analysis.Results:1.a total of 9 studies were included in the Meta-analysis of the effect of aspirin of mortality of sepsis,including 6,843 patients.The results of meta-analysis showed that compared with the non-aspirin group,early use of aspirin before the disease occurs was not associated with reducing the inpatient mortality of sepsis（OR=1.04,95%CI=（0.83,1.29）,P=0.75,I~2=0%）.On the contrary,late use of aspirin after the onset of the disease was associated with effectively reducing the mortality of sepsis（OR=0.61,95%CI=（0.54,0.69）,P<0.05,I~2=0%）;The subgroup analysis suggested that late use of aspirin was associated with reducing the mortality of sepsis patients in hospital（OR=0.63,95%CI=（0.55,0.71）,P<0.05,I~2=15.5%）and the mortality of ICU patients in hospital（OR=0.53,95%CI=（0.40,0.71）,P<0.05,I~2=0%）.2.a total of 5 studies were included in the Meta-analysis of the effect of aspirin of mortality of sepsis,including 6,208 patients.The results of meta-analysis showed that compared with the non-aspirin group,early use of aspirin before the disease occurs was not associated with reducing the ARDS inpatient mortality（OR=0.88,95%CI=（0.73,1.07）,P=0.208,I~2=0%）.Conclusion:The current evidence showed that compared with the non-aspirin group,early use of aspirin before the disease occurs did not reduce the inpatient mortality of sepsis and ARDS inpatient mortality.On the contrary,late use of aspirin could reduce both the mortality of sepsis patients in hospital and ICU patients in hospital.However,due to the limited number of studies in the included literature,more high-quality studies are still needed for further verification.