Aspirin Use significantly linked to AKI Risk in Critical Chest Trauma Patients: Study

Non-steroidal anti-inflammatory drugs (NSAIDs) are increasingly utilized in trauma patients, particularly those with critical chest trauma who are susceptible to significant blood loss, leading to renal hypoperfusion.

Acute kidney injury (AKI) is known to carry a poor prognosis in chest trauma patients. Therefore, investigating the potential association between NSAID use and acute kidney injury risk in critical patients with chest trauma is crucial. They selected patients admitted to the intensive care unit (ICU) with chest trauma from the Medical Information Mart for Intensive Care III (MIMIC-III) dataset (2001–2012) and the Medical Information Mart for Intensive Care IV (MIMIC-IV) dataset (2013–2019). Propensity score matching (PSM) was used to match patients receiving NSAIDs with those not receiving treatment. Logistic regression was employed to assess the association between different types of NSAIDs and acute kidney injury in these patients.

Results: In MIMIC-IV, NSAID use significantly increased the risk of acute kidney injury in critical patients with chest trauma (OR 1.99; 95% CI 1.04 to 3.85). Subgroup analysis revealed that aspirin significantly increased AKI risk in both MIMIC-III (OR 1.81; 95% CI 1.02 to 3.2) and MIMIC-IV (OR 2.47; 95% CI 1.26 to 4.85).

However, ibuprofen and ketorolac use were not associated with acute kidney injury in these patients. They observed a significant association between aspirin use and an elevated risk of acute kidney injury in critical patients with chest trauma. These findings suggest that pain management strategies involving ibuprofen and ketorolac may be more appropriate for this patient population.

Reference:

Huang, Y., Xu, H., Xiang, F. et al. Aspirin increases the risk of acute kidney injury in critical patients with chest trauma: a retrospective cohort study. Int J Emerg Med 18, 38 (2025). https://doi.org/10.1186/s12245-025-00835-1