Aspirin reduces the risk of death in patients with cirrhosis: a propensity-matched retrospective analysis of the MIMIC-IV database

Background Cirrhosis of the liver not only leads to high mortality rates but also carries a huge economic burden and health losses. Aspirin is a drug with potential liver disease indications. However, the benefits of aspirin in cirrhosis remain controversial. We sought to determine whether aspirin therapy has a protective effect on outcomes in patients with cirrhosis. Methods We selected patients with cirrhosis from the Medical Information Marketplace in Intensive Care IV (MIMIC-IV) database. Propensity score matching (PSM) balanced baseline differences. Multivariate Cox regression models assessed the association between aspirin therapy and 30- and 90-day mortality, and multifactorial logistic regression models assessed the association between aspirin therapy and hospital mortality. Results We included a total of 3,105 patients, of whom 346 received aspirin therapy and 2,759 did not. Following PSM, there were 321 matched pairs. Aspirin users had a 30-day mortality rate of 15.26% and a 90-day mortality rate of 16.82%, both lower than nonusers. Multifactorial Cox regression analysis indicated that aspirin use was associated with reduced 30-day mortality (HR 0.66, 95% CI 0.44–0.98) and 90-day mortality (HR 0.61, 95% CI 0.42–0.89). Multifactorial logistic regression analysis indicated that aspirin use was associated with reduced in-hospital mortality (OR 0.64, 95% CI 0.42–0.97). No significant differences were found in ICU length of stay. Conclusion Aspirin is associated with reduced 30-day, 90-day, and hospitalization mortality in cirrhotic patients.