S1128 The Impact of Aspirin Use on Outcomes in Patients With Inflammatory Bowel Disease: Insights From a National Database

Introduction: Inflammatory bowel disease (IBD) is a chronic inflammatory disorder of the gastrointestinal tract, which can lead to severe complications and increase the risk of mortality. Aspirin is an anti-inflammatory drug used for primary prevention of cardiovascular events. A single center analysis previously reported that aspirin use did not impact major outcomes. In this study, we aim to assess the impact of aspirin use on mortality and other outcomes in patients with IBD using national data. Methods: NIS 2016-2020 was used to identify adult patients(age >18 years) with IBD using ICD-10 codes. Patients with missing demographics and mortality were excluded from the analysis. Data was collected on patient demographics, hospital characteristics, Charlson Comorbidity Index (CCI), and Charlson comorbidities. Information was also collected regarding whether IBD was complicated or not. The outcomes studied were in-hospital mortality, sepsis, shock, Intensive Care Unit (ICU) admission, and need for surgery. Multivariate logistic regression analysis was performed to evaluate the impact of aspirin use on in-hospital mortality, after adjusting for patient demographics, hospital characteristics, Charlson comorbidities and Charlson Comorbidity Index (CCI). Results: A total of 1,524,820 patients were admitted in 2020. Of these, 137,430 (9%) patients were daily aspirin users. The majority of the patients in the aspirin group were aged >65 years (34.11%), female (56.37%), White (78.83%) and had Medicare insurance (36.77%). Patients with aspirin use had a lower incidence of complicated IBD (14.1% vs. 22.1%, P< 0.001). Aspirin users had a lower incidence of in-hospital mortality (1.6% vs 1.4%, P-0.06), sepsis (2.5% vs 2.9%, P< 0.001), shock (2.9% vs 3.4%, P< 0.001), ICU admission (2.6% vs 2.9%, P< 0.001), need for need for surgery (2.1% vs 4.2%, P< 0.001). The use of aspirin was associated with a significant reduction in mortality (OR: 0.49, 95% CI: 0.44-0.55, P< 0.001), even after adjusting for confounding factors (Table 1, Figure 1). Conclusion: Our study reports that aspirin use among patients with IBD was associated with a lower risk of death, sepsis, and shock. The results of the study suggest that aspirin use might have protective effect in patients with IBD.Further studies are needed to confirm these results and explore potential underlying mechanisms. Table 1. - Patient Demographics Demographics Absence of Aspirin n (%) Presence of Aspirin n (%) P- value Age category < 0.001 18-44 510,765 (36.8) 7,315 (5.3) 45-64 445,510 (32.1) 41,070 (29.9) >65 431,115 (31.1) 89,045 (64.8) Sex < 0.001 Males 597,685 (43.1) 67,475 (49.1) Females 789,705 (56.9) 69,955 (51) Race < 0.001 White 1,084,745 (78.2) 117,285 (85.3) Black 159,715 (11.5) 11,480 (8.3) Hispanic 88,310 (6.4) 4,805 (3.5) Asian/Pacific Islander 16,990 (1.2) 1,400 (1) Native American 5,260 (0.4) 415 (0.3) Other 32370 (2.3) 2,045 (1.5) Figure 1.: Effect of Aspirin Use on Outcomes.