title: Statins and outcomes in patients admitted to hospital with community acquired pneumonia: population based prospective cohort study.
abstract: 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.
authors.affiliation: Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada. me2.majumdar@ualberta.ca
authors.forename: Sumit R
authors.initials: SR
authors.lastname: Majumdar
authors.forename: Finlay A
authors.initials: FA
authors.lastname: McAlister
authors.forename: Dean T
authors.initials: DT
authors.lastname: Eurich
authors.forename: Raj S
authors.initials: RS
authors.lastname: Padwal
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Marrie
mesh_terms: 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
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors