Abstract Body (Do not enter title and authors here): Introduction
NVUGB is a known inciting event for the development of adverse cardiovascular and renal events such as ventricular arrythmias, cardiac arrest, AKI. They are typically associated with increased mortality and lengthier hospital stays however the effect of aspirin use on cardiovascular and renal outcomes remains poorly characterized in the setting of NVUGB.
Research Question
Is there an association between aspirin use and in-hospital cardiovascular and renal outcomes among patients admitted with non-variceal upper gastrointestinal bleeding
Methods
The Nationwide Inpatient Sample, NIS, database from 2017 to 2022 was analyzed for patients age >18 years who were hospitalized with a principal diagnosis of non-variceal upper gastrointestinal bleeding using ICD-10 diagnostic codes. In patient cardiovascular and renal outcomes were analyzed with Multivariate logistic regression. The Charlson Comorbidity Index was implemented to adjust for confounding variables; a p-value (pv) of <0.05 was considered statistically significant. The outcomes evaluated in this study included ventricular tachyarrhythmias, cardiac arrest, cardiogenic shock, pulmonary embolism, pulmonary hypertension and acute kidney injury, AKI.
Results
Aspirin use in those with NVUGB was associated with a significantly decreased odds of cardiac arrest (aOR 0.558, 95% CI: 0.486 – 0.640, P<0.001), cardiogenic shock (aOR 0.572, 95% CI: 0.455 – 0.719, P<0.001), pulmonary embolism (aOR 0.652, 95% CI: 0.573 – 0.742, P<0.001),pulmonary hypertension (aOR 0.886, 95% CI: 0.844 – 0.930, P<0.001). The odds of developing an AKI in those with aspirin were reduced (aOR 0.827, 95% CI: 0.807 – 0.847, P<0.001) and the odds of requiring continuous renal replacement therapy were significantly reduced with aspirin use (aOR 0.499, 95% CI: 0.356 – 0.699, P<0.001). There was no significant difference detected in the odds of developing ventricular tachyarrhythmias with aspirin use in the setting of NVUGB.
Conclusion
Patients admitted with NVUGB with concurrent use of aspirin demonstrated a significantly reduced odds ofdeveloping major adverse cardiovascular and renal outcomes. These findings reveal that aspirin exerts aprotective effect against the odds of developing majoradverse cardiovascular and renal in-hospital outcomes.