Effect of pre-ICU aspirin use on neuroinflammation and outcomes in patients with sepsis-associated encephalopathy

TL;DR

This study found that using aspirin before ICU admission may improve brain blood flow and reduce inflammation in patients with sepsis-related brain dysfunction, leading to better long-term survival.

Contribution

The study demonstrates that pre-ICU aspirin use is associated with improved cerebral hemodynamics and reduced neuroinflammation in sepsis-associated encephalopathy patients.

Findings

Pre-ICU aspirin use was linked to improved cerebral hemodynamics (Vm, Vd, Vs) in SAE patients.

Aspirin use reduced levels of neuroinflammation markers (IL-6, TNF-α, S100β) in SAE patients.

Aspirin use was associated with higher GCS scores and lower 60-day mortality in SAE patients.

Abstract

To investigate the effect of pre-ICU aspirin use on neuroinflammation and prognosis in sepsis-associated encephalopathy (SAE) patients.

Clinical data of SAE patients admitted to our ICU (Mar 2022–Feb 2025) were retrospectively analyzed. Patients were grouped based on pre-admission aspirin use: exposed (n = 45) and non-exposed (n = 68). After 1:1 propensity score matching (age, infection source; caliper = 0.2), 42 matched pairs were compared. Cerebral hemodynamics (Vm, Vd, and Vs), coagulation function (PLT, TT, PT, and APTT), neuroinflammation markers (IL-6, TNF-α, and S100β), Glasgow Coma Scale (GCS), Sequential Organ Failure Assessment (SOFA) scores (admission, days 1, 3, and 5), ICU length of stay, adverse events, 28- and 60-day mortality were analyzed using appropriate statistical tests (t-test, χ2 test; P < 0.05 significant).

The exposed group had higher Vm, Vd, and Vs at all time points (P < 0.05). IL-6, TNF-α, and S100β levels were lower in the exposed group (P < 0.05). GCS scores were higher in the exposed group on days 3 and 5 (P < 0.05). Adverse event incidence, ICU stay, and 28-day mortality did not differ significantly (P < 0.05). The 60-day mortality was lower in the exposed group (P < 0.05).

Pre-ICU aspirin use can improve cerebral hemodynamics, reduce neuroinflammation, and improve 60-day survival in SAE patients without increasing adverse reactions.

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