Association of statin therapy and increased survival in patients with multiple organ dysfunction syndrome.
OBJECTIVE
The multiple organ dysfunction syndrome (MODS) is the sequential failure of several organ systems after a trigger event, such as sepsis, pneumonia or cardiogenic shock. Even today, mortality is high. Statin therapy is associated with reduction of inflammation and subsequent rates of severe sepsis and ICU admission of patients admitted to hospital with presumed or documented acute bacterial infection. Our study aimed to characterize a potential survival benefit by statin therapy in MODS patients.


METHODS
Retrospective cohort study.


METHODS
Twelve-bed medical intensive care unit in a university center.


METHODS
Forty score-defined MODS patients under statin treatment and 80 age- and sex-matched score-defined MODS patients without statin treatment. Inclusion criterion was an APACHE II score > or = 20 at admission to ICU.


METHODS
Assessment of statin treatment and calculation of disease severity by scoring. The patients were followed up for 28-day mortality as well as for hospital mortality.


RESULTS
The MODS severity was equally pronounced in both groups. There were 42/80 deaths in the group without statin treatment and 13/40 deaths in the statin group (28-day mortality 53% vs. 33%, p = 0.03). Cox proportional hazard analysis revealed a hazard ratio of 0.53 (95% CI 0.29-0.99, p = 0.04). Hospital mortality was calculated at 72% (non-statin group) vs. 35% (statin group; chi-square = 15.6, p < 0.0001). The overall hospital mortality was 60%.


CONCLUSIONS
Patients under statin treatment developing MODS might have a better outcome than patients without statin therapy, probably by reduction of inflammatory responses and increase of vagal activity in MODS.
Schmidt
Hendrik
H
Department of Medicine III, Martin Luther University Halle-Wittenberg, Klinikum Kröllwitz, Ernst-Grube-Strasse 40, 06097 Halle/Saale, Germany. hendrik.schmidt@medizin.uni-halle.de
Hennen
Ralf
R
Keller
Alexander
A
Russ
Martin
M
Müller-Werdan
Ursula
U
Werdan
Karl
K
Buerke
Michael
M
D000069059:Atorvastatin; D015331:Cohort Studies; D005260:Female; D006538:Heptanoic Acids / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000188:drug therapy* / Q000401:mortality*; D017035:Pravastatin / Q000627:therapeutic use*; D011758:Pyrroles / Q000627:therapeutic use*; D012189:Retrospective Studies; D019821:Simvastatin / Q000627:therapeutic use*; D015996:Survival Rate
D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D000069059:Atorvastatin; D019821:Simvastatin; D017035:Pravastatin