Statin administration did not influence the progression of lung injury or associated organ failures in a cohort of patients with acute lung injury.
OBJECTIVE
Preclinical studies suggest that HMG-CoA reductase inhibitors (statins) may attenuate organ dysfunction. We evaluated whether statins are associated with attenuation of lung injury and prevention of associated organ failure in patients with ALI/ARDS.


METHODS
From a database of patients with ALI/ARDS, we determined the presence and timing of statin administration. Main outcome measures were the development and progression of pulmonary and nonpulmonary organ failures as assessed by changes in PaO(2)/FiO(2) ratio and Sequential Organ Failure Assessment score (SOFA) between days 1 and 7 after the onset of ALI/ARDS. Secondary outcomes included ventilator free days, ICU and hospital mortality, and lengths of ICU and hospital stay.


RESULTS
From 178 patients with ALI/ARDS, 45 (25%) received statin therapy. From day 1 to day 7, the statin group showed less improvement in their PaO(2)/FiO(2) ratio (27 vs. 55, P = 0.042). Ventilator free days (median 21 vs. 16 days, P = 0.158), development or progression of organ failures (median DeltaSOFA 1 vs. 2, P = 0.275), ICU mortality (20% vs. 23%, P = 0.643), and hospital mortality (27 vs. 37%, P = 0.207) were not significantly different in the statin and non-statin groups. After adjustment for baseline characteristics and propensity for statin administration, there were no differences in ICU or hospital lengths of stay.


CONCLUSIONS
In this retrospective cohort study, statin use was not associated with improved outcome in patients with ALI/ARDS. We were unable to find evidence for protection against pulmonary or nonpulmonary organ dysfunction.
Kor
Daryl J
DJ
Division of Critical Care Medicine, Department of Anesthesiology, Multidisciplinary Epidemiology and Translational Research in Intensive Care, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905, USA. kor.daryl@mayo.edu
Iscimen
Remzi
R
Yilmaz
Murat
M
Brown
Michael J
MJ
Brown
Daniel R
DR
Gajic
Ognjen
O
D055371:Acute Lung Injury / Q000517:prevention & control*; D000368:Aged; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000517:prevention & control*; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors