title: Statin therapy is associated with fewer deaths in patients with bacteraemia.
abstract: OBJECTIVE
  Beneficial effects with statin use are increasingly reported in a variety of patient groups. There is in vitro and clinical evidence for its antiinflammatory and immunomodulatory therapeutic roles. We aimed to assess the association between statin administration and mortality in bacteraemic patients.
  
  
  METHODS
  A retrospective cohort analysis.
  
  
  METHODS
  A 300-bed acute general hospital.
  
  
  METHODS
  All patients (n=438) requiring hospital care for an episode of bacteraemia during the years 2000-2003 were included. Statin use, patient outcome, and clinical and laboratory variables were collected.
  
  
  METHODS
  None.
  
  
  RESULTS
  There was a significant reduction in all-cause hospital mortality (10.6% vs. 23.1%, p=0.022) and death attributable to bacteraemia (6.1% vs. 18.3%, p=0.014) in patients who were receiving statin therapy at the time of bacteraemia (n=66). The reduction in all-cause hospital mortality (1.8% vs. 23.1%, p=0.0002) and death attributable to bacteraemia (1.8% vs. 18.3%, p=0.0018) was more pronounced in the patients who continued to receive statin therapy after the diagnosis of bacteraemia (n=56). The apparent mortality benefit persisted after controlling for differences between the groups. Statin use prior to admission was associated with a reduced adjusted hospital mortality rate (odds ratio 0.39; CI 95% 0.17, 0.91; p=0.029), and continuing statin use after bacteraemia increased this effect (odds ratio 0.06; CI 95% 0.01, 0.44; p=0.0056).
  
  
  CONCLUSIONS
  This retrospective study demonstrates a significant survival benefit associated with continuing statin therapy in bacteraemic patients. The potential for statins as an adjuvant therapy in sepsis warrants further investigation.
authors.affiliation: Intensive Care Unit, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, 4102 Brisbane, Queensland, Australia. peter_kruger@health.qld.gov.au
authors.forename: Peter
authors.initials: P
authors.lastname: Kruger
authors.forename: Kenneth
authors.initials: K
authors.lastname: Fitzsimmons
authors.forename: David
authors.initials: D
authors.lastname: Cook
authors.forename: Mark
authors.initials: M
authors.lastname: Jones
authors.forename: Graeme
authors.initials: G
authors.lastname: Nimmo
mesh_terms: D000328:Adult; D016470:Bacteremia / Q000188:drug therapy*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors