Impact of previous statin and angiotensin II receptor blocker use on mortality in patients hospitalized with sepsis.
OBJECTIVE
To examine the effect of previous outpatient use of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) and/or angiotensin II receptor blockers (ARBs) on 30-day mortality in patients hospitalized with sepsis.


METHODS
Retrospective national cohort study.


METHODS
Department of Veterans Affairs (VA) national patient care and pharmacy databases.


METHODS
A total of 3018 patients who were hospitalized with sepsis in fiscal year 2000, had at least 1 year of previous VA outpatient care, and had at least one active and filled VA prescription within 90 days of admission.


RESULTS
The primary outcome was 30-day mortality. The primary analysis was a multilevel model with hospital as a random effect and control variables that included comorbid conditions, demographics, and other drugs. Among the 3018 patients hospitalized with sepsis, mean age was 74.4 years, 2975 (98.6%) were male, and 811 (26.9%) died within 30 days of admission. Regarding prescription drug use, 480 patients (15.9%) were taking statins and 107 (3.5%) were taking ARBs. After adjusting for potential confounders, statin use (odds ratio [OR] 0.48, 95% confidence interval [CI] 0.36-0.64) and ARB use (OR 0.42, 95% CI 0.24-0.76) were significantly associated with decreased 30-day mortality.


CONCLUSIONS
Use of statins and/or ARBs before admission was associated with decreased mortality in patients hospitalized with sepsis. Further research is needed to determine if these drugs might be started on admission for those with sepsis.
VERDICT Research Center, South Texas Veterans Health Care System, San Antonio, Texas 78284, USA. mortensene@uthscsa.edu
Eric M
EM
Mortensen
Marcos I
MI
Restrepo
Laurel A
LA
Copeland
Jacqueline A
JA
Pugh
Antonio
A
Anzueto
John E
JE
Cornell
Mary Jo V
MJ
Pugh
D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D017052:Hospital Mortality; D006787:Hospitals, Veterans; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D016017:Odds Ratio; D012189:Retrospective Studies; D018805:Sepsis / Q000188:drug therapy* / Q000401:mortality*; D013997:Time Factors; D014481:United States
D047228:Angiotensin II Type 1 Receptor Blockers; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors