Statins and outcomes in patients admitted to hospital with community acquired pneumonia: population based prospective cohort study.
OBJECTIVE
To determine whether statins reduce mortality or need for admission to intensive care in patients admitted to hospital with community acquired pneumonia; and to assess whether previously reported improvements in sepsis related outcomes were a result of the healthy user effect.


METHODS
Population based prospective cohort study.


METHODS
Six hospitals in Capital Health, Edmonton, Alberta, Canada.


METHODS
Adults admitted to hospital with pneumonia and categorised according to use of statins for at least one week before admission and during hospital stay.


METHODS
Composite of in-hospital mortality or admission to an intensive care unit.


RESULTS
Of 3415 patients with pneumonia admitted to hospital, 624 (18%) died or were admitted to an intensive care unit. Statin users were less likely to die or be admitted to an intensive care unit than non-users (50/325 (15%) v 574/3090 (19%), odds ratio 0.80, P=0.15). After more complete adjustment for confounding, however, the odds ratios changed from potential benefit (0.78, adjusted for age and sex) to potential harm (1.10, fully adjusted including propensity scores, 95% confidence interval 0.76 to 1.60).


CONCLUSIONS
Statins are not associated with reduced mortality or need for admission to an intensive care unit in patients with pneumonia; reports of benefit in the setting of sepsis may be a result of confounding.
Majumdar
Sumit R
SR
Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada. me2.majumdar@ualberta.ca
McAlister
Finlay A
FA
Eurich
Dean T
DT
Padwal
Raj S
RS
Marrie
Thomas J
TJ
D000368:Aged; D000416:Alberta / Q000453:epidemiology; D015331:Cohort Studies; D017714:Community-Acquired Infections / Q000188:drug therapy* / Q000401:mortality; D005260:Female; D015989:Healthy Worker Effect; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D018410:Pneumonia, Bacterial / Q000188:drug therapy* / Q000401:mortality; D011446:Prospective Studies; D012044:Regression Analysis; D016896:Treatment Outcome
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors