Although new immunotherapies have been used, hepatocellular carcinoma (HCC) still presents a low survival rate. Aspirin (ASA) shows a reduction in HCC. However, the effects of long-term aspirin use on in-hospital outcomes need investigation.

To investigate the impact of long-term aspirin use on in-hospital outcomes of patients with hepatocellular carcinoma (HCC), researchers conducted a retrospective analysis utilizing the National Inpatient Sample (NIS) database spanning from 2016 to 2020. Patients diagnosed with HCC were divided into two groups based on long-term aspirin usage. They collected data on patient demographics, Elixhauser comorbidities, interventions, etiology, and liver disease decompensations. The outcomes of interest included sepsis, shock, acute kidney injury, ICU admission, and in-hospital mortality. They employed multivariate analysis to assess the association between long-term aspirin use and these outcomes.

The study encompassed 224,735 patients, among whom 18,835 (8.4%) were identified as long-term aspirin users. Within the aspirin group, the majority were White individuals (61.3%), male (78.2%), and aged over 65 years (68.8%). Compared to non-aspirin users, patients in the aspirin group exhibited a higher prevalence of non-alcoholic steatohepatitis (NASH) and lower rates of hepatic decompensation. Additionally, patients using aspirin demonstrated lower incidences of sepsis (2.76% vs. 3.54%), shock (4.86% vs. 8.23%), acute kidney injury (AKI) (30.9% vs. 33.4%), ICU admission (3.88% vs. 7.4%), and in-hospital mortality (5.18% vs. 9.87%). Following adjustment for confounding factors, long-term aspirin use was associated with a 30% reduced risk of in-hospital mortality (adjusted odds ratio [aOR] 0.70, 95% CI 0.60-0.82, p<0.001). Aspirin users also exhibited a 21% lower odds of developing shock (aOR 0.79, 95% CI 0.67-0.94, p=0.007) and a 31% lower odds of requiring ICU admission (aOR 0.69, 95% CI 0.54-0.78, p<0.001). No statistically significant difference between the two groups was observed in the risk of sepsis and AKI.

Study findings indicated that patients on long-term aspirin use had superior in-hospital outcomes, including reduced mortality, lower rates of shock, and fewer ICU admissions compared to those who did not use aspirin. These results were noteworthy and highlighted the potential benefits of aspirin in enhancing outcomes for patients with HCC. However, further randomized clinical trials must be conducted to confirm the improved outcomes in HCC patients.