Highlights
Antiplatelet
drugs can reduce the mortality rate in patients with sepsis.
Aspirin can
effectively reduce mortality in patients with sepsis.
Antiplatelet
drugs reduce mortality regardless of the timing of administration.
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 less than 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 less than 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.
Antithrombotic
therapy for sepsis is not a new concept. The coagulation system is
activated and accounts for some of the injury in sepsis. Activated
protein C was found beneficial in selected septic patients and was
approved as an adjunct in the treatment of sepsis with organ
dysfunction in 2001. The company withdrew the product from the
market in 2011.
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