Background. Sepsis is characterized by dysfunctional activation of platelets, and antiplatelet therapy could improve the outcomes of septic patients. Methods. We performed a retrospective cohort study of severe sepsis or septic shock adult patients. Outcomes of patients on antiplatelet therapy were compared to those that were not taking antiplatelet therapy by univariate analysis followed by a propensity score analysis based on the probability of receiving antiplatelet therapy. Results. Of 651 patients included in the study 272 (42.8%) were on antiplatelet therapy before the development of severe sepsis or septic shock. After adjusting for important confounding variables antiplatelet therapy was not associated with a decreased risk of hospital mortality (odds ratio 0.73, 95% confidence interval 0.46–1.16). Antiplatelet therapy was associated with a decreased incidence of acute respiratory distress syndrome/acute lung injury (odds ratio 0.50, 95% confidence interval 0.35–0.71) and reduced need of mechanical ventilation (odds ratio 0.62, 95% confidence interval 0.45–87). Incidence of acute kidney injury was similar between both groups (odds ratio 1.08, 95% confidence interval 0.73–1.59). Conclusions. The use of antiplatelet therapy before the diagnosis of severe sepsis or septic shock was not associated with decreased hospital mortality. Antiplatelet therapy was associated with a decreased incidence of acute lung injury/acute respiratory distress syndrome. 1. Introduction Sepsis and its more severe forms (severe sepsis and septic shock) are frequent indications for Intensive Care Unit (ICU) admission [1] and commonly lead to multiple-organ dysfunction syndrome that is the main cause of death in critically ill patients [2]. There is strong evidence that sepsis, through the release of inflammatory mediators such as interleukin 1, 6 [3, 4], and tumor necrosis factor？？ ？？[5], produces a dysfunctional activation of the hemostatic system [6, 7]. The resulting development of microvascular thrombosis is tightly related to associated organ failure and death [8]. Inflammation-driven activation of platelets plays a key role in this complex process [9] in which platelets are capable of recruiting and activating neutrophils, thereby, intensifying the inflammatory response. Preclinical studies have shown beneficial effects of antiplatelets on the outcome of septic subjects [10–12]. Moreover, antiplatelet therapy has been associated with decreased incidence of systemic inflammatory response syndrome [13], decreased mortality in ICU patients [14–16] as well as with
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