Association of prior antiplatelet agents with mortality in sepsis patients: a nationwide population-based cohort study

Background: Antiplatelet agents are widely used for cardiovascular diseases, but their pleiotropic effects in sepsis are controversial. Objective: To investigate the association between antiplatelet agents and the survival benefit for sepsis patients. Design: A nationwide population-based cohort and nested case–control study. Setting: Taiwan National Health Insurance database. Participants: All patients (age ≥18 years) who were hospitalized for sepsis between January 2000 and December 2010. Measurements: Conditional logistic regression was used to adjust for confounding. Adjusted odd ratios (ORs) were used to compare the mortality rate due to sepsis in antiplatelet drug users and nonusers. Results: Of 683,421 included patients, 229,792 (33.6 %) patients died during hospitalization for sepsis, and the rest (64.4 %) survived to discharge. Use of antiplatelet agents before admission was associated with a lower risk of mortality in sepsis patients (aOR 0.82, 95 % confidence interval [CI] 0.81–0.83, P < 0.001). By using another case–control study design, the beneficial effect was more significant in current users (aOR 0.78, 95 % CI 0.76–0.79) than in recent users (aOR 0.88, 95 % CI 0.85–0.91), but was not significant in past users (aOR 1.00, 95 % CI 0.98–1.02). Limitations: Observational study. Conclusions: Prior use of antiplatelet agents was associated with a survival benefit in sepsis patients.