title: The effect of statins on mortality in septic patients: a meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  Statins are among the most prescribed drugs worldwide and their recently discovered anti-inflammatory effect seems to have an important role in inhibiting proinflammatory cytokine production, chemokines expression and counteracting the harmful effects of sepsis on the coagulation system. We decided to perform a meta-analysis of all randomized controlled trials ever published on statin therapy in septic patients to evaluate their effect on survival and length of hospital stay.
  
  
  METHODS
  Articles were assessed by four trained investigators, with divergences resolved by consensus. BioMedCentral, PubMed, Embase and the Cochrane Central Register of clinical trials were searched for pertinent studies. Inclusion criteria were random allocation to treatment and comparison of statins versus any comparator in septic patients.
  
  
  METHODS
  Data from 650 patients in 5 randomized controlled studies were analyzed. No difference in mortality between patients receiving statins versus control (44/322 [14%] in the statins group vs 50/328 [15%] in the control arm, RR = 0.90 [95% CI 0.65 to 1.26], p = 0.6) was observed. No differences in hospital stay (p = 0.7) were found.
  
  
  CONCLUSIONS
  Published data show that statin therapy has no effect on mortality in the overall population of adult septic patients. Scientific evidence on statins role in septic patients is still limited and larger randomized trials should be performed on this topic.
authors.affiliation: Department of Anesthesia and Intensive Care, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Pasin
authors.affiliation: Department of Anesthesia and Intensive Care, San Raffaele Scientific Institute, Milan, Italy ; Maieutics Foundation, Milan, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Landoni
authors.affiliation: Anesthesiology Department, Centro Hospitalar Lisboa Central, Lisbon, Portugal.
authors.forename: Maria Lourdes
authors.initials: ML
authors.lastname: Castro
authors.affiliation: Department of Anesthesia and Intensive Care, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Cabrini
authors.affiliation: Department of Anesthesia and Intensive Care, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Belletti
authors.affiliation: Department of Anesthesia and Intensive Care, University Hospital of Padua, Padua, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Feltracco
authors.affiliation: Department of Medical Sciences "M. Aresu", Cagliari University, Cagliari, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Finco
authors.affiliation: Department of Anesthesia and Intensive Care, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Carozzo
authors.affiliation: Department of Vascular Surgery, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Chiesa
authors.affiliation: Department of Anesthesia and Intensive Care, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Zangrillo
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001777:Blood Coagulation / Q000187:drug effects; D016207:Cytokines / Q000096:biosynthesis; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D018836:Inflammation Mediators / Q000378:metabolism; D016032:Randomized Controlled Trials as Topic; D018805:Sepsis / Q000188:drug therapy* / Q000401:mortality* / Q000503:physiopathology
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D016207:Cytokines; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D018836:Inflammation Mediators