Low-dose aspirin use is associated with reduced 30- and 90-day mortality and overall improved outcomes in patients with acute pancreatitis: A multinational multicenter analysis.

Introduction: Studies regarding outcomes in patients with acute pancreatitis (AP) on aspirin (ASA) have shown conflicting results. This study aims to evaluate the association between low-dose ASA and clinical outcomes in patients with AP at 30 and 90 days.

Methods: This retrospective cohort study used Global Research Network from TriNetX. Patients with AP on low-dose ASA were matched 1:1 with non-ASA users by demographics and comorbidities. Outcomes included mortality, shock, intensive care unit (ICU) admission, mechanical ventilation, venous thromboembolism (VTE), acute kidney injury (AKI), pancreatic pseudocyst formation, development of necrotizing pancreatitis, and recurrent AP. Hazard ratios (HR) and 95 % confidence intervals (CI) were calculated at 30 and 90 days.

Results: A total of 240 720 patients with AP were identified of which 12 634 were ASA users. 12 389 ASA users (mean age 60.4 years, 48.8 % female) were matched with 12 389 non-users (mean age 60.7 years, 48.4 % female). ASA users had lower risk of 30-day mortality (HR: 0.53, 95 %CI: 0.43-0.64), shock (HR: 0.57, 95 %CI: 0.37-0.88), ICU admission (HR: 0.71, 95 %CI: 0.56-0.89), VTE (HR: 0.38, 95 %CI: 0.24-0.60), AKI (HR: 0.69, 95 %CI: 0.59-0.80), and recurrent AP (HR: 0.64, 95 %CI: 0.60-0.67). Similar trends were observed at 90 days.

Conclusion: Low-dose ASA was associated with lower mortality, fewer complications, and lower recurrence in patients with AP, as compared to patients without ASA use at 30- and 90-days. These findings may suggest that ASA's anti-inflammatory and antiplatelet properties could potentially mitigate the inflammatory cascade in AP pathophysiology. Further studies are warranted to explore the direct impact of ASA on AP.