Preadmission statin use and one-year mortality among patients in intensive care - a cohort study.
BACKGROUND
Statins reduce risk of cardiovascular events and have beneficial pleiotropic effects; both may reduce mortality in critically ill patients. We examined whether statin use was associated with risk of death in general intensive care unit (ICU) patients.


METHODS
Cohort study of 12,483 critically ill patients > 45 yrs of age with a first-time admission to one of three highly specialized ICUs within the Aarhus University Hospital network, Denmark, between 2001 and 2007. Statin users were identified through population-based prescription databases. We computed cumulative mortality rates 0-30 days and 31-365 days after ICU admission and mortality rate ratios (MRRs), using Cox regression analysis controlling for potential confounding factors (demographics, use of other cardiovascular drugs, comorbidity, markers of social status, diagnosis, and surgery).


RESULTS
1882 (14.3%) ICU patients were current statin users. Statin users had a reduced risk of death within 30 days of ICU admission [users: 22.1% vs. non-users 25.0%; adjusted MRR = 0.76 (95% confidence interval (CI): 0.69 to 0.86)]. Statin users also had a reduced risk of death within one year after admission to the ICU [users: 36.4% vs. non-users 39.9%; adjusted MRR = 0.79 (95% CI: 0.73 to 0.86)]. Reduced risk of death associated with current statin use remained robust in various subanalyses and in an analysis using propensity score matching. Former use of statins and current use of non-statin lipid-lowering drugs were not associated with reduced risk of death.


CONCLUSIONS
Preadmission statin use was associated with reduced risk of death following intensive care. The associations seen could be a pharmacological effect of statins, but unmeasured differences in characteristics of statin users and non-users cannot be entirely ruled out.
Christensen
Steffen
S
Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes alle 43-45, Arhus N, Denmark. steffchris@hotmail.com
Thomsen
Reimar W
RW
Johansen
Martin B
MB
Pedersen
Lars
L
Jensen
Reinhold
R
Larsen
Kim M
KM
Larsson
Anders
A
Tønnesen
Else
E
Sørensen
Henrik Toft
HT
D000368:Aged; D015331:Cohort Studies; D016638:Critical Illness / Q000401:mortality; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D010343:Patient Admission; D016016:Proportional Hazards Models; D018570:Risk Assessment
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors