{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:37:55Z","timestamp":1792791475973,"version":"4.5.0"},"reference-count":36,"publisher":"SAGE Publications","license":[{"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":["J Intensive Care Med"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The association between aspirin and mortality in patients with sepsis remains unclear. This study aimed to systematically evaluate the effects of aspirin on mortality and major bleeding in adults with sepsis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This review was registered in Open Science Framework (DOI: 10.17605\/OSF.IO\/E5K87). We searched MEDLINE, Embase, CENTRAL, ICTRP, and ClinicalTrials.gov through May 9, 2025. We included one randomized controlled trial (RCT) and four non-randomized studies of interventions (NRSIs). Risk of bias was assessed using RoB 2 for RCTs and ROBINS-I for NRSIs. Random-effects meta-analysis was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Five studies involving 25\u2005138 patients were included. Aspirin showed a possible reduction in mortality (RR 0.77, 95% CI 0.66-0.89; I\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200961.9%), but the certainty of evidence was very low. No clear effect was observed on major bleeding (OR 1.20, 95% CI 0.46-3.11; I\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200977.3%), also with very low certainty. Data for secondary outcomes (SOFA score, ICU length of stay) was sparse and very uncertain. Subgroup analyses showed no evidence of effect modification by aspirin timing or treatment setting, and sensitivity analyses limited to Sepsis-3 studies and exclusion of Wang et al produced similar results. Evidence was limited by the predominance of NRSIs, heterogeneity in sepsis definitions, and variability in dosing and timing of aspirin.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The evidence is very uncertain regarding the effect of aspirin on mortality or bleeding in sepsis. Routine aspirin use for patients with sepsis cannot be recommended. For patients already receiving aspirin before hospitalization, continuation should be guided by clinical judgment. Further high-quality RCTs are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08850666261464950","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T13:24:57Z","timestamp":1782912297000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Effect of Acetylsalicylic Acid on Mortality in Sepsis: A Systematic Review and Meta-Analysis"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-6539-1797","authenticated-orcid":false,"given":"Yusuke","family":"Hirao","sequence":"first","affiliation":[{"name":"University of Hawai\u2019i"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3372-010X","authenticated-orcid":false,"given":"Shunsuke","family":"Kondo","sequence":"additional","affiliation":[{"name":"University of Hawai\u2019i"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brent","family":"Matsuda","sequence":"additional","affiliation":[{"name":"University of Hawai\u2019i"},{"name":"The Queen's Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4511-4672","authenticated-orcid":false,"given":"Eriya","family":"Imai","sequence":"additional","affiliation":[{"name":"Mitsui Memorial Hospital"},{"name":"Department of Social Medical Sciences, Graduate School of Medicine, International University of Health and Welfare, Minato, Japan"},{"name":"Scientific Research WorkS Peer Support Group (SRWS-PSG)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Miyashita","sequence":"additional","affiliation":[{"name":"Cleveland Clinic"},{"name":"Juntendo University Faculty of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Kataoka","sequence":"additional","affiliation":[{"name":"Scientific Research WorkS Peer Support Group (SRWS-PSG)"},{"name":"Center for Postgraduate Clinical Training and Career Development"},{"name":"Center for Medical Education, Graduate School of Medicine, Nagoya University, Nagoya, Japan"},{"name":"Kyoto Min-iren Asukai Hospital"},{"name":"Department of Healthcare Epidemiology, Kyoto University Graduate School of Medicine \/ Public Health, Kyoto, Japan"},{"name":"Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Miyagi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)32989-7"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa022139"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2016.11.007"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/jth.13911"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-012-2570-8"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2018.12.004"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0322293"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0287"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000006564"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000050454.01978.3B"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.101.6.1644"},{"key":"e_1_3_2_13_2","unstructured":"Hirao Y Kondo S Matsuda B Imai E Kataoka Y. 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