Impact of aspirin on pancreatic cancer in the elderly: analysis of socioeconomic status and outcomes of national matched cohorts.

Background: Pancreatic cancer is a neoplastic condition with a high disease burden. It is projected to be the second most common cause of cancer-related deaths by 2030. However, evidence supporting the long-term use of aspirin in cancer prevention and treatment remains insufficient. We aimed to investigate the association between aspirin use and pancreatic cancer outcomes in the elderly population group.

Methods: The 2020 National Inpatient Sample was used to investigate records of elderly patients admitted with pancreatic cancer, identified by ICD-10 CM codes. The data were categorized based on long-term aspirin use. We assessed inpatient mortality as the primary outcome, while secondary outcomes included costs and length of stay, as well as other inpatient complications.

Results: We identified 19,249 hospitalizations of patients aged over 60 years. The mean age was 73.8 years, and 49.3% were male. In a survey multivariate logistic and linear regression model, adjusting for patient characteristics and hospital factors, long-term aspirin use was associated with lower inpatient mortality (adjusted odds ratio [aOR] 0.55, 95% confidence interval [CI] 0.33-0.92; P=0.023), a shorter hospital stay (beta coefficient -0.52, 95%CI -0.93 to -0.11; P=0.012), lower odds of acute kidney injury (aOR 0.76, 95%CI 0.59-0.98; P=0.039), and lower odds of shock (aOR 0.23, 95%CI 0.06-0.78; P=0.019]. Post-propensity matching revealed similar patterns.

Conclusions: Long-term aspirin use is associated with a lower rate of inpatient mortality and other clinical outcomes in hospitalized elderly patients with pancreatic cancer. The etiologies behind this relationship should be explored with a view to better understanding.