title: Effect of preinjury statin use on mortality and septic shock in elderly burn patients.
abstract: BACKGROUND
  Premorbid statin use has been associated with decreased mortality in septic and trauma patients. This has been ascribed to the pleiotropic, anti-inflammatory effects of HMG-CoA reductase inhibitors. This association has not been investigated in burn victims.
  
  
  METHODS
  A retrospective review of 223 consecutive patients, aged 55 years and older admitted to Vanderbilt University Regional Burn Center from January 2006 to December 2008, was performed. Multivariate regression analysis determined odds ratios of death and sepsis by statin use, adjusting for cardiovascular comorbidities.
  
  
  RESULTS
  Of 223 patients, 70 (31.4%) were taking statins before admission. Mean age and mean total body surface area burn were not significantly different by statin use. The odds ratio of inhospital death was 0.17 (95% confidence interval 0.05-0.57; p = 0.004) if on statins. The odds ratio of mortality when stratified by cardiovascular comorbidities did not change. Sepsis developed in 30 patients (13.5%), with an odds ratio in statin users of 0.50 (95% confidence interval 0.20-1.30; p = 0.155).
  
  
  CONCLUSIONS
  Preinjury statin use was associated with an 83% reduction in the odds of death after thermal injury. The odds of sepsis decreased by 50%, although not statistically significant. Further study is warranted to investigate the potential benefits of statin therapy in the management of burn victims.
authors.affiliation: Department of Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee, USA. mary.d.fogerty@vanderbilt.edu
authors.forename: Mary D
authors.initials: MD
authors.lastname: Fogerty
authors.forename: David
authors.initials: D
authors.lastname: Efron
authors.forename: Alessandro
authors.initials: A
authors.lastname: Morandi
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Guy
authors.forename: Naji N
authors.initials: NN
authors.lastname: Abumrad
authors.forename: Adrian
authors.initials: A
authors.lastname: Barbul
mesh_terms: D000368:Aged; D002056:Burns / Q000150:complications / Q000401:mortality*; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012044:Regression Analysis; D012189:Retrospective Studies; D012772:Shock, Septic / Q000209:etiology*
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors