Is Prior Aspirin Use Associated with Reduced Severity in Patients with Acute Pancreatitis?

Abstract

Clinical severity of Acute Pancreatitis (AP)following the use of Aspirin is inconclusive in previous studies. This study investigated predicting the severity of AP using Ranson criteria at admission and at 48 hours and, the length of hospital stay by prior aspirin use. Medical records of first-presentation AP patients during the five years between 2010 and 2015 were examined in the Goulburn Valley Base Hospital, Victoria, Australia. Uses of aspirin at admission with some co-morbidity, Ranson criteria at admission and at 48 hours, duration of hospital stay including other information were collected. A total of 245 AP medical records were reviewed, of them, 178 used and 67 did not use aspirin prior attending to the hospital. In simple regression analysis, Ranson score was 60% higher at admission (P< 0.001) and 64% higher at 48 hours (P <0.01) among aspirin users compared to non-aspirin users. These findings remained statistically significant after adjusting for other potential indicators. Aspirin use was also found associated with a longer hospital stay both in the unadjusted and adjusted analysis (P<0.01). Further studies using revised Atlanta classification instead of Ranson scoring for the diagnosis of AP severity in aspirin users are critical for clinical guidance.

Does use of long-term aspirin impact outcomes in patients with acute pancreatitis?

“…In a study of 192 patients with acute pancreatitis in the USA, aspirin decreased the severity of acute pancreatitis at 24 h and 48 h of admission, based on Ranson's score [7]. Another study in Australia on 245 patients with acute pancreatitis reported that patients with aspirin use had higher Ranson's scores at admission and at 48 h of admission [8]. Although Ranson's score could not be used to assess severity in our study, we used surrogate markers of severity such as ICU admission, shock, in-hospital mortality as well as acute pancreatitis-DRG severity criteria.…”

“…A small pilot study in 192 patients revealed aspirin use was associated with decreased severity at 24 h and 48 h in patients with acute pancreatitis [7]. Another study containing 245 patients with acute pancreatitis in Australia revealed that aspirin use was significantly associated with higher Ranson scores, both at admission and at 48 h of admission [8]. On the contrary, some case reports have documented that the use of aspirin over a long period of time may trigger acute pancreatitis [9].…”