title: Effect of statin treatment on three-month outcomes in patients with stroke-associated infection: a prospective cohort study.
abstract: OBJECTIVE
  Infection is a major medical problem in patients with acute stroke. Recent evidences suggest that statins reduce infection-associated complications. The purpose of this study was to examine the influence of statin treatment on mortality and functional outcomes in patients with stroke-associated infection.
  
  
  METHODS
  In this prospective observational cohort study, 514 patients with acute ischaemic stroke or transient ischaemic attack (mean age, 74 ± 11 years; men, 48%) with infection occurring in the first 7 days after admission were included. We examined the effect of in-hospital statin treatment on mortality and favorable functional outcome (modified Rankin Scale score ≤2) at 3 months follow-up.
  
  
  RESULTS
  Infection occurred at 0.93 ± 1.49 days after admission. All patients had not received statin treatment prior to admission, and 121 patients (24%) received statin at 1.71 ± 1.28 days after admission. Follow-up at 3 months was completed for 511 patients (99%). National Institutes of Health Stroke Scale score and Charlson index were the most important independent predictors of mortality and functional outcome. Univariate [hazard ratio (HR), 0.82; 95% confidence intervals (CI), 0.47-1.42] and multivariate (HR, 1.68; 95% CI, 0.79-3.56) Cox regression analysis showed that statin did not significantly decrease the morality. In propensity analysis, statin treatment still had no significant association with mortality (HR, 1.54; 95% CI, 0.68-3.47) in the multivariate analyses after adjusting for age, sex, and propensity score.
  
  
  CONCLUSIONS
  Statin use was not associated with a better functional outcome or survival in patients with stroke-associated infection.
authors.affiliation: Department of Neurology, Chi-Mei Medical Center, Tainan, Taiwan.
authors.forename: P-S
authors.initials: PS
authors.lastname: Yeh
authors.forename: H-J
authors.initials: HJ
authors.lastname: Lin
authors.forename: P-S
authors.initials: PS
authors.lastname: Chen
authors.forename: S-H
authors.initials: SH
authors.lastname: Lin
authors.forename: W-M
authors.initials: WM
authors.lastname: Wang
authors.forename: C-M
authors.initials: CM
authors.lastname: Yang
authors.forename: Y-H
authors.initials: YH
authors.lastname: Li
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D002452:Cell Count / Q000379:methods; D015331:Cohort Studies; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007239:Infections / Q000188:drug therapy / Q000209:etiology* / Q000401:mortality; D053208:Kaplan-Meier Estimate; D007962:Leukocytes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D020521:Stroke / Q000150:complications* / Q000188:drug therapy* / Q000401:mortality; D013997:Time Factors
chemical_list: D000924:Anticholesteremic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors