title: Effect of statins on the clinical outcomes of patients with sepsis.
abstract: Despite numerous attempts at novel intervention and tests to aid in earlier diagnosis and improved treatment, there has been an increased incidence of overall mortality related to sepsis, despite improvements in in-hospital mortality. Statins have emerged as potential immunomodulatory and antioxidant agents that might impact on sepsis outcomes. Definitive evidence to support the routine use of statins in patients with sepsis has not yet been elicited. We retrospectively analysed data from patients who presented with sepsis, severe sepsis or septic shock, stratifiying them according to statin use into two groups (statin and no statin). Sequential Organ Failure Assessment was used to evaluate severity of illness. The primary outcome was hospital mortality. Secondary outcomes included intensive care unit (ICU) mortality, hospital and ICU length of stay, and mechanical ventilation and vasopressor therapy duration. Five hundred and sixty-eight patients were included. Patients with prior statin use (statin group) were older; more obese and had higher prevalence of smoking, diabetes and ischaemic heart disease. There was no difference in Sequential Organ Failure Assessment scores and mortality did not vary between the two groups (19.6 vs. 16.9%). Furthermore, secondary outcomes including ICU mortality, hospital and ICU length of stay, mechanical ventilation and vasopressor duration did not differ Multivariate analysis revealed age and Sequential Organ Failure Assessment score were independent predictors of survival, while history of statin use was not (p = 0.403). This current retrospective study did not find any benefit of statin use on primary and secondary outcomes of the patients admitted to an academic hospital with sepsis.
authors.affiliation: Division of Pulmonary, Critical Care and Environmental Medicine, University of Missouri School of Medicine, Columbia, Missouri 65212, USA.
authors.forename: J
authors.initials: J
authors.lastname: Goodin
authors.forename: C
authors.initials: C
authors.lastname: Manrique
authors.forename: M
authors.initials: M
authors.lastname: Dulohery
authors.forename: J
authors.initials: J
authors.lastname: Sampson
authors.forename: M
authors.initials: M
authors.lastname: Saettele
authors.forename: O
authors.initials: O
authors.lastname: Dabbagh
mesh_terms: D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D018805:Sepsis / Q000401:mortality*; D012772:Shock, Septic / Q000401:mortality; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008077:Lipoproteins, LDL