Acetylsalicylic acid use is associated with improved survival in bacteremic pneumococcal pneumonia: A long‐term nationwide study
Abstract Background Pneumonia is commonly caused by Streptococcus pneumoniae (pneumococcus) and associated with subsequent cardiovascular complications and increased mortality. Potential short‐term survival benefits conferred by acetylsalicylic acid (ASA) use in pneumonia remain controversial, and l...
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crwiley:10.1111/joim.13485 2024-09-15T18:14:27+00:00 Acetylsalicylic acid use is associated with improved survival in bacteremic pneumococcal pneumonia: A long‐term nationwide study Rögnvaldsson, Kristján G. Bjarnason, Agnar Kristinsson, Karl Bragason, Hörður T. Erlendsdóttir, Helga Þorgeirsson, Guðmundur Gottfreðsson, Magnús Icelandic Centre for Research 2022 http://dx.doi.org/10.1111/joim.13485 https://onlinelibrary.wiley.com/doi/pdf/10.1111/joim.13485 https://onlinelibrary.wiley.com/doi/full-xml/10.1111/joim.13485 en eng Wiley http://creativecommons.org/licenses/by-nc/4.0/ Journal of Internal Medicine volume 292, issue 2, page 321-332 ISSN 0954-6820 1365-2796 journal-article 2022 crwiley https://doi.org/10.1111/joim.13485 2024-08-27T04:29:21Z Abstract Background Pneumonia is commonly caused by Streptococcus pneumoniae (pneumococcus) and associated with subsequent cardiovascular complications and increased mortality. Potential short‐term survival benefits conferred by acetylsalicylic acid (ASA) use in pneumonia remain controversial, and long‐term outcomes have not been studied. Objectives To evaluate the association between ASA use and survival for up to 1 year following bacteremic pneumococcal pneumonia. Methods All bacteremic pneumococcal episodes in Iceland from 1975 to 2019 were reviewed. The study cohort consisted of individuals at least 18 years of age with symptoms and imaging results consistent with pneumonia. Differences in survival were assessed at 30 days, 90 days and 1 year using propensity score weighting (inverse probability weighting). Splitting and stratifying on survival at 7 days was done for the 30‐day survival, because of nonproportionality. Results In total, 815 bacteremic pneumococcal pneumonia episodes (median age 67 years, females 48%) were identified. Cox regression using propensity score weighting on the association of ASA with survival at 30 days showed an average hazard ratio (HR) of 0.60 (95% confidence interval [CI] 0.34–1.05). A significantly improved survival was observed within 7 days (HR = 0.42, 95% CI 0.19–0.92) but not during days 7–30 (HR = 1.08, 95% CI 0.46–2.55). ASA was associated with survival at 90 days (HR = 0.53, 95% CI 0.32–0.87) and 1 year (HR = 0.48, 95% CI 0.31–0.75). Conclusion Use of ASA upon admission for bacteremic pneumococcal pneumonia is associated with significantly reduced mortality for up to 1 year after diagnosis. ASA therapy in patients with pneumonia and other infectious syndromes warrants further study. Article in Journal/Newspaper Iceland Wiley Online Library Journal of Internal Medicine 292 2 321 332 |
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English |
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Abstract Background Pneumonia is commonly caused by Streptococcus pneumoniae (pneumococcus) and associated with subsequent cardiovascular complications and increased mortality. Potential short‐term survival benefits conferred by acetylsalicylic acid (ASA) use in pneumonia remain controversial, and long‐term outcomes have not been studied. Objectives To evaluate the association between ASA use and survival for up to 1 year following bacteremic pneumococcal pneumonia. Methods All bacteremic pneumococcal episodes in Iceland from 1975 to 2019 were reviewed. The study cohort consisted of individuals at least 18 years of age with symptoms and imaging results consistent with pneumonia. Differences in survival were assessed at 30 days, 90 days and 1 year using propensity score weighting (inverse probability weighting). Splitting and stratifying on survival at 7 days was done for the 30‐day survival, because of nonproportionality. Results In total, 815 bacteremic pneumococcal pneumonia episodes (median age 67 years, females 48%) were identified. Cox regression using propensity score weighting on the association of ASA with survival at 30 days showed an average hazard ratio (HR) of 0.60 (95% confidence interval [CI] 0.34–1.05). A significantly improved survival was observed within 7 days (HR = 0.42, 95% CI 0.19–0.92) but not during days 7–30 (HR = 1.08, 95% CI 0.46–2.55). ASA was associated with survival at 90 days (HR = 0.53, 95% CI 0.32–0.87) and 1 year (HR = 0.48, 95% CI 0.31–0.75). Conclusion Use of ASA upon admission for bacteremic pneumococcal pneumonia is associated with significantly reduced mortality for up to 1 year after diagnosis. ASA therapy in patients with pneumonia and other infectious syndromes warrants further study. |
author2 |
Icelandic Centre for Research |
format |
Article in Journal/Newspaper |
author |
Rögnvaldsson, Kristján G. Bjarnason, Agnar Kristinsson, Karl Bragason, Hörður T. Erlendsdóttir, Helga Þorgeirsson, Guðmundur Gottfreðsson, Magnús |
spellingShingle |
Rögnvaldsson, Kristján G. Bjarnason, Agnar Kristinsson, Karl Bragason, Hörður T. Erlendsdóttir, Helga Þorgeirsson, Guðmundur Gottfreðsson, Magnús Acetylsalicylic acid use is associated with improved survival in bacteremic pneumococcal pneumonia: A long‐term nationwide study |
author_facet |
Rögnvaldsson, Kristján G. Bjarnason, Agnar Kristinsson, Karl Bragason, Hörður T. Erlendsdóttir, Helga Þorgeirsson, Guðmundur Gottfreðsson, Magnús |
author_sort |
Rögnvaldsson, Kristján G. |
title |
Acetylsalicylic acid use is associated with improved survival in bacteremic pneumococcal pneumonia: A long‐term nationwide study |
title_short |
Acetylsalicylic acid use is associated with improved survival in bacteremic pneumococcal pneumonia: A long‐term nationwide study |
title_full |
Acetylsalicylic acid use is associated with improved survival in bacteremic pneumococcal pneumonia: A long‐term nationwide study |
title_fullStr |
Acetylsalicylic acid use is associated with improved survival in bacteremic pneumococcal pneumonia: A long‐term nationwide study |
title_full_unstemmed |
Acetylsalicylic acid use is associated with improved survival in bacteremic pneumococcal pneumonia: A long‐term nationwide study |
title_sort |
acetylsalicylic acid use is associated with improved survival in bacteremic pneumococcal pneumonia: a long‐term nationwide study |
publisher |
Wiley |
publishDate |
2022 |
url |
http://dx.doi.org/10.1111/joim.13485 https://onlinelibrary.wiley.com/doi/pdf/10.1111/joim.13485 https://onlinelibrary.wiley.com/doi/full-xml/10.1111/joim.13485 |
genre |
Iceland |
genre_facet |
Iceland |
op_source |
Journal of Internal Medicine volume 292, issue 2, page 321-332 ISSN 0954-6820 1365-2796 |
op_rights |
http://creativecommons.org/licenses/by-nc/4.0/ |
op_doi |
https://doi.org/10.1111/joim.13485 |
container_title |
Journal of Internal Medicine |
container_volume |
292 |
container_issue |
2 |
container_start_page |
321 |
op_container_end_page |
332 |
_version_ |
1810452220850733056 |