World J Oncol

World Journal of Oncology, ISSN 1920-4531 print, 1920-454X online, Open Access

Article copyright, the authors; Journal compilation copyright, World J Oncol and Elmer Press Inc

Journal website https://www.wjon.org

Original Article

Volume 14, Number 3, June 2023, pages 195-204

Impact of Aspirin Use on Outcomes in Patients With Hepatocellular Cancer: A Nationwide Analysis

**Table 1.** Patient Characteristics, Stratified by the Use of Aspirin
Demographics	No aspirin use, n (%)	Aspirin use, n (%)	P value
*P < 0.05.
Age category
18 - 44	6,025 (2.93)	115 (0.61)	< 0.001*
45 - 64	95,745 (46.5)	5,770 (30.63)
> 65	104,130 (50.57)	12,950 (68.75)
Sex
Male	153,110 (74.4)	14,735 (78.23)	< 0.001*
Female	52,790 (25.64)	4,100 (21.8)
Race
White	112,575 (54.67)	11,540 (61.27)	< 0.001*
Black	31,325 (15.21)	3,480 (18.48)
Hispanic	36,885 (17.91)	2,265 (12.03)
Asian/Pacific Islander	14,875 (7.22)	935 (4.96)
Native American	2,040 (0.99)	150 (0.80)
Other	8,200 (3.98)	465 (2.47)
Primary expected payer
Medicare	108,920 (52.9)	12,715 (67.51)	< 0.001*
Medicaid	40,480 (19.66)	2,270 (12.05)
Private	42,205 (20.5)	3,055 (16.22)
Uninsured	6,425 (3.12)	230 (1.22)
Median household income
Lowest quartile	66,725 (32.41)	6,155 (32.68)	0.74
Second quartile	52,195 (25.35)	4,675 (24.82)
Third quartile	47,065 (22.86)	4,235 (22.48)
Highest quartile	39,915 (19.39)	3,770 (20.02)
Hospital region
Northeast	41,300 (20.06)	3,625 (19.25)	< 0.001*
Midwest	35,695 (17.34)	4,480 (23.79)
South	77,620 (37.7)	6,890 (36.58)
West	51,285 (24.91)	3,840 (20.39)
Hospital location
Rural	7,135 (3.47)	645 (3.43)	0.91
Urban	198,765 (96.53)	18,190 (96.58)
Hospital teaching status
Non-teaching hospitals	36,055 (17.51)	2,995 (15.9)	0.02*
Teaching hospitals	169,845 (82.49)	15,840 (84.1)
Hospital bed size
Small	29,565 (14.36)	2,820 (14.97)	0.62
Medium	50,220 (24.39)	4,620 (24.53)
Large	126,115 (61.25)	11,395 (60.5)
Elixhauser comorbidities
0	1,745 (.85)	90 (0.48)	< 0.001*
1	6,985 (3.39)	345 (1.83)
2	16,975 (8.24)	945 (5.01)
> 3	180,195 (87.52)	17,455 (92.67)

Table 1. Patient Characteristics, Stratified by the Use of Aspirin

Demographics

No aspirin use, n (%)

Aspirin use, n (%)

P value

*P < 0.05.

Age category

18 - 44

6,025 (2.93)

115 (0.61)

< 0.001*

45 - 64

95,745 (46.5)

5,770 (30.63)

> 65

104,130 (50.57)

12,950 (68.75)

Sex

Male

153,110 (74.4)

14,735 (78.23)

< 0.001*

Female

52,790 (25.64)

4,100 (21.8)

Race

White

112,575 (54.67)

11,540 (61.27)

< 0.001*

Black

31,325 (15.21)

3,480 (18.48)

Hispanic

36,885 (17.91)

2,265 (12.03)

Asian/Pacific Islander

14,875 (7.22)

935 (4.96)

Native American

2,040 (0.99)

150 (0.80)

Other

8,200 (3.98)

465 (2.47)

Primary expected payer

Medicare

108,920 (52.9)

12,715 (67.51)

< 0.001*

Medicaid

40,480 (19.66)

2,270 (12.05)

Private

42,205 (20.5)

3,055 (16.22)

Uninsured

6,425 (3.12)

230 (1.22)

Median household income

Lowest quartile

66,725 (32.41)

6,155 (32.68)

0.74

Second quartile

52,195 (25.35)

4,675 (24.82)

Third quartile

47,065 (22.86)

4,235 (22.48)

Highest quartile

39,915 (19.39)

3,770 (20.02)

Hospital region

Northeast

41,300 (20.06)

3,625 (19.25)

< 0.001*

Midwest

35,695 (17.34)

4,480 (23.79)

South

77,620 (37.7)

6,890 (36.58)

West

51,285 (24.91)

3,840 (20.39)

Hospital location

Rural

7,135 (3.47)

645 (3.43)

0.91

Urban

198,765 (96.53)

18,190 (96.58)

Hospital teaching status

Non-teaching hospitals

36,055 (17.51)

2,995 (15.9)

0.02*

Teaching hospitals

169,845 (82.49)

15,840 (84.1)

Hospital bed size

Small

29,565 (14.36)

2,820 (14.97)

0.62

Medium

50,220 (24.39)

4,620 (24.53)

Large

126,115 (61.25)

11,395 (60.5)

Elixhauser comorbidities

1,745 (.85)

90 (0.48)

< 0.001*

6,985 (3.39)

345 (1.83)

16,975 (8.24)

945 (5.01)

> 3

180,195 (87.52)

17,455 (92.67)

**Table 2.** Comorbidities, Stratified by the Presence of Aspirin Use
Comorbidities	No aspirin use, n (%)	Aspirin use, n (%)	P value
*P < 0.05. AIDS: acquired immunodeficiency syndrome; HIV: human immunodeficiency virus.
Congestive heart failure	26,690 (12.96)	4,615 (24.5)	< 0.001*
Cardiac arrhythmias	36,830 (17.89)	4,940 (26.23)	< 0.001*
Valvular disease	8,740 (4.25)	1,640 (8.71)	< 0.001*
Pulmonary circulation disorders	9,585 (4.66)	1,065 (5.65)	0.0084*
Peripheral vascular disorders	11,720 (5.7)	2,220 (11.79)	< 0.001*
Hypertension, uncomplicated	79,850 (38.78)	9,135 (48.5)	< 0.001*
Paralysis	2,340 (1.14)	190 (1.00)	0.4792
Other neurological disorders	25,765 (12.51)	1,975 (10.49)	0.0004*
Chronic pulmonary disease	39,600 (19.23)	4,680 (24.85)	< 0.001*
Diabetes, uncomplicated	36,055 (17.51)	4,320 (22.94)	< 0.001*
Diabetes, complicated	43,370 (21.06)	5,885 (31.25)	< 0.001*
Hypothyroidism	21,115 (10.25)	2,245 (11.92)	0.0016*
Renal failure	41,860 (20.33)	4,950 (26.28)	< 0.001*
Peptic ulcer disease excluding bleeding	3,765 (1.83)	345 (1.83)	0.9893
AIDS/HIV	1,515 (0.74)	60 (0.32)	0.0028*
Lymphoma	1,580 (0.77)	170 (0.90)	0.3617
Metastatic cancer	41,030 (19.93)	3,155 (16.75)	< 0.001*
Rheumatoid arthritis/collagen vascular disorders	3,415 (1.66)	335 (1.78)	0.5915
Coagulopathy	73,960 (35.92)	4,345 (23.07)	< 0.001*
Obesity	21,185 (10.29)	2,590 (13.75)	< 0.001*
Malnutrition	46,050 (22.37)	3,090 (16.41)	< 0.001*
Fluid and electrolyte disorders	108,240 (52.57)	8,375 (44.47)	< 0.001*
Blood loss anemia	4,650 (2.26)	305 (1.62)	0.0107*
Deficiency anemia	13,730 (6.67)	1,265 (6.72)	0.9107
Alcohol abuse	60,010 (29.15)	3,545 (18.82)	< 0.001*
Drug abuse	14,605 (7.09)	860 (4.57)	< 0.001*
Psychoses	2,655 (1.29)	180 (0.96)	0.0886
Depression	21,365 (10.38)	2,195 (11.65)	0.0165*
Hypertension, complicated	44,695 (21.71)	6,480 (34.4)	< 0.001*

Table 2. Comorbidities, Stratified by the Presence of Aspirin Use

Comorbidities

No aspirin use, n (%)

Aspirin use, n (%)

P value

*P < 0.05. AIDS: acquired immunodeficiency syndrome; HIV: human immunodeficiency virus.

Congestive heart failure

26,690 (12.96)

4,615 (24.5)

< 0.001*

Cardiac arrhythmias

36,830 (17.89)

4,940 (26.23)

< 0.001*

Valvular disease

8,740 (4.25)

1,640 (8.71)

< 0.001*

Pulmonary circulation disorders

9,585 (4.66)

1,065 (5.65)

0.0084*

Peripheral vascular disorders

11,720 (5.7)

2,220 (11.79)

< 0.001*

Hypertension, uncomplicated

79,850 (38.78)

9,135 (48.5)

< 0.001*

Paralysis

2,340 (1.14)

190 (1.00)

0.4792

Other neurological disorders

25,765 (12.51)

1,975 (10.49)

0.0004*

Chronic pulmonary disease

39,600 (19.23)

4,680 (24.85)

< 0.001*

Diabetes, uncomplicated

36,055 (17.51)

4,320 (22.94)

< 0.001*

Diabetes, complicated

43,370 (21.06)

5,885 (31.25)

< 0.001*

Hypothyroidism

21,115 (10.25)

2,245 (11.92)

0.0016*

Renal failure

41,860 (20.33)

4,950 (26.28)

< 0.001*

Peptic ulcer disease excluding bleeding

3,765 (1.83)

345 (1.83)

0.9893

AIDS/HIV

1,515 (0.74)

60 (0.32)

0.0028*

Lymphoma

1,580 (0.77)

170 (0.90)

0.3617

Metastatic cancer

41,030 (19.93)

3,155 (16.75)

< 0.001*

Rheumatoid arthritis/collagen vascular disorders

3,415 (1.66)

335 (1.78)

0.5915

Coagulopathy

73,960 (35.92)

4,345 (23.07)

< 0.001*

Obesity

21,185 (10.29)

2,590 (13.75)

< 0.001*

Malnutrition

46,050 (22.37)

3,090 (16.41)

< 0.001*

Fluid and electrolyte disorders

108,240 (52.57)

8,375 (44.47)

< 0.001*

Blood loss anemia

4,650 (2.26)

305 (1.62)

0.0107*

Deficiency anemia

13,730 (6.67)

1,265 (6.72)

0.9107

Alcohol abuse

60,010 (29.15)

3,545 (18.82)

< 0.001*

Drug abuse

14,605 (7.09)

860 (4.57)

< 0.001*

Psychoses

2,655 (1.29)

180 (0.96)

0.0886

Depression

21,365 (10.38)

2,195 (11.65)

0.0165*

Hypertension, complicated

44,695 (21.71)

6,480 (34.4)

< 0.001*

**Table 3.** Etiology and Decompensations, Stratified by the Presence of Aspirin Use
	No aspirin use, n (%)	Aspirin use, n (%)	P value
*P < 0.05. NASH: non-alcoholic steatohepatitis; SBP: spontaneous bacterial peritonitis.
Etiology of liver disease
Alcohol-related liver disease	48,900 (23.75)	2,725 (14.47)	< 0.001*
NASH	16,735 (8.13)	1,755 (9.32)	0.01*
Hepatitis B	13,865 (6.73)	840 (4.46)	< 0.001*
Hepatitis C	83,130 (40.37)	6,055 (32.15)	< 0.001*
Decompensations
Hepatic encephalopathy	60,030 (29.15)	3,620 (19.22)	< 0.001*
Ascites	86,610 (42.06)	5,210 (27.66)	< 0.001*
Varices	9,790 (4.76)	510 (2.71)	< 0.001*
SBP	8,535 (4.15)	320 (1.70)	< 0.001*
Hepatorenal syndrome	13,390 (6.50)	490 (2.60)	< 0.001*

Table 3. Etiology and Decompensations, Stratified by the Presence of Aspirin Use

No aspirin use, n (%)

Aspirin use, n (%)

P value

*P < 0.05. NASH: non-alcoholic steatohepatitis; SBP: spontaneous bacterial peritonitis.

Etiology of liver disease

Alcohol-related liver disease

48,900 (23.75)

2,725 (14.47)

< 0.001*

NASH

16,735 (8.13)

1,755 (9.32)

0.01*

Hepatitis B

13,865 (6.73)

840 (4.46)

< 0.001*

Hepatitis C

83,130 (40.37)

6,055 (32.15)

< 0.001*

Decompensations

Hepatic encephalopathy

60,030 (29.15)

3,620 (19.22)

< 0.001*

Ascites

86,610 (42.06)

5,210 (27.66)

< 0.001*

Varices

9,790 (4.76)

510 (2.71)

< 0.001*

SBP

8,535 (4.15)

320 (1.70)

< 0.001*

Hepatorenal syndrome

13,390 (6.50)

490 (2.60)

< 0.001*

**Table 4.** Results of Multivariate Logistic Regression Identifying Association Between Aspirin and Categorical Outcomes
	Odds ratio	95% confidence interval	P value
*P < 0.05. AKI: acute kidney injury; ICU: intensive care unit.
Death	0.7	0.60 - 0.82	< 0.001*
Sepsis	0.88	0.71 - 1.08	0.213
Shock	0.79	0.67 - 0.94	0.007*
AKI	1.02	0.93 - 1.11	0.727
ICU	0.65	0.54 - 0.78	< 0.001*

Table 4. Results of Multivariate Logistic Regression Identifying Association Between Aspirin and Categorical Outcomes

Odds ratio

95% confidence interval

P value

*P < 0.05. AKI: acute kidney injury; ICU: intensive care unit.

Death

0.7

0.60 - 0.82

< 0.001*

Sepsis

0.88

0.71 - 1.08

0.213

Shock

0.79

0.67 - 0.94

0.007*

AKI

1.02

0.93 - 1.11

0.727

ICU

0.65

0.54 - 0.78

< 0.001*