title: Statin therapy is associated with decreased mortality in patients with infection.
abstract: OBJECTIVE
  The objective was to investigate the association between statin therapy and mortality in emergency department (ED) patients with suspected infection.
  
  
  METHODS
  A secondary analysis of a prospective, observational cohort study was conducted at an urban, academic ED with approximately 50,000 annual visits. Data were collected between December 2003 and September 2004. Inclusion criteria consisted of age > or = 18 years, clinical suspicion of infection, and hospital admission. Patients were divided by those receiving statin therapy and those not receiving statins while hospitalized. Medication data were collected from an inpatient pharmacy database. Comparisons were conducted with Fisher's exact test or Wilcoxon rank sum test. To adjust for baseline differences, multivariable logistic regression analysis controlling for gender, severity of illness (Mortality in Emergency Department Sepsis [MEDS] score), Charlson Comorbidity Index, and duration of statin therapy was performed.
  
  
  RESULTS
  Of 2,132 patients with suspected infection, 2,036 (95%) had interpretable pharmacy data and were analyzed. The cohort had a median age of 61 years (interquartile range [IQR] = 46-78 years) and a mortality of 3.9% (95% confidence interval [CI] = 3.1% to 4.8%). Patients who received statins (n = 474) had a lower unadjusted crude mortality (1.9%; 95% CI = 0.6% to 3.3%) compared to those who did not (4.5%; 95% CI = 3.4% to 5.4%; p </= 0.01). When adjusting for gender, MEDS score, Charlson Comorbidity Index, and duration of statin therapy, the odds of death for statin patients was 0.27 (95% CI = 0.1 to 0.72; p < or = 0.01).
  
  
  CONCLUSIONS
  Patients who were admitted to the hospital with infection and received statin therapy while hospitalized had a significantly lower in-hospital mortality compared to patients who did not receive a statin.
authors.affiliation: Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA. mdonnino@bidmc.harvard.edu
authors.forename: Michael W
authors.initials: MW
authors.lastname: Donnino
authors.forename: Michael N
authors.initials: MN
authors.lastname: Cocchi
authors.forename: Michael
authors.initials: M
authors.lastname: Howell
authors.forename: Peter
authors.initials: P
authors.lastname: Clardy
authors.forename: Daniel
authors.initials: D
authors.lastname: Talmor
authors.forename: Lauren
authors.initials: L
authors.lastname: Cataldo
authors.forename: Maureen
authors.initials: M
authors.lastname: Chase
authors.forename: Adel
authors.initials: A
authors.lastname: Al-Marshad
authors.forename: Long
authors.initials: L
authors.lastname: Ngo
authors.forename: Nathan I
authors.initials: NI
authors.lastname: Shapiro
mesh_terms: D000368:Aged; D015897:Comorbidity; D004636:Emergency Service, Hospital; D005260:Female; D017052:Hospital Mortality; D006786:Hospitals, Urban; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007239:Infections / Q000401:mortality*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors