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Effects of antiplatelet therapy on the mortality rate of patients with sepsis: A meta-analysis

J Crit Care. 2019 Apr:50:162-168. doi: 10.1016/j.jcrc.2018.12.004. Epub 2018 Dec 5.

Abstract

Purpose: Abnormal platelet activation plays an important role in the development of sepsis. The effect of antiplatelet drugs on the outcome of patients with sepsis remains unclear. This meta-analysis aimed to determine the effect of antiplatelet drugs on the prognosis of patients with sepsis.

Materials and methods: PubMed, Cochrane Library, CBM, and Embase were searched for all related articles published from inception to April 2018. The primary end point was mortality. Adjusted data were used and statistically analysed.

Results: Ten cohort studies were included. The total number of patients with sepsis was 689,897. Data showed that the use of antiplatelet drugs could effectively reduce the mortality of patients with sepsis (odds ratio (OR) = 0.82, 95% CI: 0.81-0.83, p < 0.05). Seven studies used aspirin for antiplatelet therapy, and subgroup analysis showed that aspirin effectively reduced ICU or hospital mortality in patients with sepsis (OR = 0.60, 95% CI: 0.53-0.68, p < 0.05). A subgroup analysis on the timing of anti-platelet drug administration showed that antiplatelet drugs can reduce mortality when administered either before (OR = 0.78, 95% CI: 0.77-0.80) or after sepsis (OR = 0.59, 95% CI: 0.52-0.67).

Conclusions: Antiplatelet drugs, particularly aspirin, could be used to effectively reduce mortality in patients with sepsis.

Keywords: Antiplatelet; Aspirin; Mortality; Sepsis.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aspirin / administration & dosage*
  • Critical Care / methods
  • Drug Administration Schedule
  • Hospital Mortality*
  • Humans
  • Intensive Care Units
  • Models, Statistical
  • Odds Ratio
  • Platelet Aggregation Inhibitors / administration & dosage*
  • Prognosis
  • Sepsis / drug therapy*
  • Sepsis / mortality*

Substances

  • Platelet Aggregation Inhibitors
  • Aspirin