• Min-Juei Tsai, Shuo-Ming Ou, Chia-Jen Shih, Pei-Wen Chao, Lan-Fu Wang, Yu-Ning Shih, Szu-Yuan Li, Shu-Chen Kuo, Yen-Tao Hsu, and Yung-Tai Chen.
• Department of Internal Medicine, Taipei Veterans General Hospital, Suao Branch, Yilan, Taiwan.
• Intensive Care Med. 2015 May 1;41(5):806-13.

BackgroundAntiplatelet agents are widely used for cardiovascular disea ses, but their pleiotropic effects in sepsis are controversial.ObjectiveTo investigate the association between antiplatelet agents and the survival benefit for sepsis patients.DesignA nationwide population-based cohort and nested case-control study.SettingTaiwan National Health Insurance database.ParticipantsAll patients (age ≥18 years) who were hospitalized for sepsis between January 2000 and December 2010.MeasurementsConditional 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.ResultsOf 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).LimitationsObservational study.ConclusionsPrior use of antiplatelet agents was associated with a survival benefit in sepsis patients.

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