{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T05:58:43Z","timestamp":1790747923398,"version":"4.1.0"},"reference-count":43,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Science Progress"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To evaluate the association between aspirin administration\n                      <jats:bold>during<\/jats:bold>\n                      the first 24 hours of intensive care unit (ICU) admission and 28-day all-cause mortality among critically ill adults with cerebral embolism and to explore associations with early cumulative dose.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective cohort study used MIMIC-IV version 3.1\n                      <jats:bold>and included each patient\u2019s first<\/jats:bold>\n                      eligible adult ICU\n                      <jats:bold>admission<\/jats:bold>\n                      . Aspirin exposure was defined as at least one documented administration\n                      <jats:bold>within<\/jats:bold>\n                      24 hours. After 1:1 propensity-score matching, 125\n                      <jats:bold>matched<\/jats:bold>\n                      pairs were\n                      <jats:bold>obtained<\/jats:bold>\n                      . Associations were examined using Kaplan\u2013Meier methods and Cox\n                      <jats:bold>proportional hazards<\/jats:bold>\n                      models, with exploratory dose, subgroup, and sensitivity analyses.\n                      <jats:bold>Given<\/jats:bold>\n                      only 45 deaths, a parsimonious Cox model was prioritized over the approximately 40-variable saturated model.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The cohort included 568 patients (430 aspirin-exposed and 138 unexposed), with 45 deaths by day 28. Aspirin exposure was associated with lower 28-day mortality before matching (HR 0.32, 95% CI 0.18-0.58; P&lt;0.001) and after matching (HR 0.31, 95% CI 0.13-0.73; P=0.008). Matching improved balance,\n                      <jats:bold>but<\/jats:bold>\n                      residual imbalance remained; the largest absolute post-match standardized mean difference in\n                      <jats:xref ref-type=\"table\">Table 1<\/jats:xref>\n                      was 0.177. The parsimonious adjusted model produced a similar estimate (HR 0.31, 95% CI 0.17-0.57; P&lt;0.001). Dose analyses were exploratory\n                      <jats:bold>and hypothesis-generating<\/jats:bold>\n                      ; sparse dose-specific events, nonrandom treatment selection, and time-related exposure classification\n                      <jats:bold>prevented identification of an optimal<\/jats:bold>\n                      dose. Laboratory abnormalities were examined only as exploratory surrogates; clinical bleeding was not ascertained.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      In this single-center retrospective cohort, aspirin exposure\n                      <jats:bold>during<\/jats:bold>\n                      the first 24 hours of ICU admission was associated with lower 28-day mortality. Residual confounding by unmeasured neurologic stroke severity\n                      <jats:bold>(because NIHSS was unavailable<\/jats:bold>\n                      ), treatment eligibility, and goals of care, together with the absence of adjudicated bleeding outcomes, precludes causal\n                      <jats:bold>, safety,<\/jats:bold>\n                      or dose-prescriptive conclusions\n                      <jats:bold>. Multicenter<\/jats:bold>\n                      prospective\n                      <jats:bold>studies and adequately powered randomized controlled trials are<\/jats:bold>\n                      required\n                      <jats:bold>before definitive clinical recommendations can be made<\/jats:bold>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00368504261484697","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T19:26:52Z","timestamp":1787945212000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["First-24-hour aspirin exposure and 28-day mortality in critically ill adults with cerebral embolism: A retrospective MIMIC-IV cohort study"],"prefix":"10.1177","volume":"109","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-7165-2757","authenticated-orcid":false,"given":"Xi","family":"Zhu","sequence":"first","affiliation":[{"name":"The Fifth Affiliated Hospital of Xinjiang Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xujie","family":"Wang","sequence":"additional","affiliation":[{"name":"The Affiliated Hospital of Qinghai University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuyi","family":"Fan","sequence":"additional","affiliation":[{"name":"The Fifth Affiliated Hospital of Xinjiang Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6716-9904","authenticated-orcid":false,"given":"Xuhui","family":"Liu","sequence":"additional","affiliation":[{"name":"The Second Hospital of Lanzhou University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Halamujiang","family":"Sailike","sequence":"additional","affiliation":[{"name":"The Fifth Affiliated Hospital of Xinjiang Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"key":"e_1_3_9_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/1747493016684843"},{"key":"e_1_3_9_3_2","first-page":"35","article-title":"Risk factors for and incidence of subtypes of ischemic stroke","volume":"27","author":"Ihle-Hansen H","year":"2012","unstructured":"Ihle-Hansen H, Thommessen B, Wyller TB, et al. 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