Effect on in-hospital outcomes of patients with hepatocellular carcinoma on aspirin.

e16162 Background: Despite the use of new immunotherapies, hepatocellular carcinoma (HCC) has a poor survival rate. Through multiple molecular mechanisms, aspirin (ASA) has demonstrated a reduced incidence of HCC, however, the impact of long-term aspirin use on in-hospital outcomes has not been studied. Methods: We queried the National Inpatient Sample (NIS) database from 2016 to 2020 to identify patients with HCC. Patients were stratified into two groups, based on long-term aspirin use. Information was collected regarding patient demographics, Elixhauser comorbidities, interventions, etiology and decompensations of the liver disease. Outcomes studied included sepsis, shock, acute kidney injury, ICU admission, and in-hospital mortality. The association between long-term aspirin use and outcomes was studied using multivariate analysis. Results: 224,735 patients were included in the study. Of them, 18,835 (8.4%) patients were on long-term aspirin. The majority of the patients with ASA use were White (61.3%), men (78.2%), and aged > 65 years old (68.8%). Patients in the ASA group had a higher incidence of NASH and decreased rates of hepatic decompensation than those not on ASA. Patients with aspirin use had lower incidence of sepsis (2.76% vs 3.54%), shock (4.86% vs 8.23%), AKI (30.9% vs 33.4%), ICU admission (3.88% vs 7.4%) and in-hospital mortality (5.18% vs 9.87%). After adjusting for confounding factors, ASA use was associated with a 30% lower risk of in-hospital mortality (aOR-0.70, 95% CI-0.60-0.82, p<0.001). ASA users also had a 21% lower odds of developing shock (aOR-0.79, 95% CI-0.67-0.94, p-0.007) and 31% lower odds of requiring ICU admission (aOR-0.69, 95% CI-0.54-0.78, p<0.001). No statistically significant difference was noted in the risk of sepsis and AKI between the two groups. Conclusions: Our study noted that patients on long-term aspirin use had better in-hospital outcomes such as mortality, shock and ICU admissions compared to non-aspirin users. These findings are of interest, and further randomized clinical trials confirming the benefits of aspirin in improving outcomes in HCC patients need to be conducted. [Table: see text]