title: Effect of statin therapy on mortality from infection and sepsis: a meta-analysis of randomized and observational studies.
abstract: BACKGROUND
  Observational data have suggested that statin therapy may reduce mortality in patients with infection and sepsis; however, results from randomized studies are contradictory and do not support the use of statins in this context. Here, we performed a meta-analysis to investigate the effects of statin therapy on mortality from infection and sepsis.
  
  
  METHODS
  We searched electronic databases (PubMed and Embase) for articles published before November 2013. Randomized or observational studies reporting the effects of statin therapy on mortality in patients with infection or sepsis were eligible. Randomized and observational studies were separately pooled with relative risks (RRs) and random-effects models.
  
  
  RESULTS
  We examined 5 randomized controlled trials with 867 patients and 27 observational studies with 337,648 patients. Among the randomized controlled trials, statins did not significantly decrease in-hospital mortality (RR, 0.98; 95% confidence interval (CI), 0.73 to 1.33) or 28-day mortality (RR, 0.93; 95% CI, 0.46 to 1.89). However, observational studies indicated that statins were associated with a significant decrease in mortality with adjusted data (RR, 0.65; 95% CI, 0.57 to 0.75) or unadjusted data (RR, 0.74; 95% CI, 0.59 to 0.94).
  
  
  CONCLUSIONS
  Limited evidence suggests that statins may not be associated with a significant reduction in mortality from infection and sepsis. Although meta-analysis from observational studies showed that the use of statins was associated with a survival advantage, these outcomes were limited by high heterogeneity and possible bias in the data. Therefore, we should be cautious about the use of statins in infection and sepsis.
authors.forename: You-Dong
authors.initials: YD
authors.lastname: Wan
authors.forename: Tong-Wen
authors.initials: TW
authors.lastname: Sun
authors.forename: Quan-Cheng
authors.initials: QC
authors.lastname: Kan
authors.forename: Fang-Xia
authors.initials: FX
authors.lastname: Guan
authors.forename: Shu-Guang
authors.initials: SG
authors.lastname: Zhang
mesh_terms: D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007239:Infections / Q000188:drug therapy / Q000401:mortality; D064887:Observational Studies as Topic / Q000401:mortality; D016032:Randomized Controlled Trials as Topic / Q000401:mortality; D018805:Sepsis / Q000188:drug therapy* / Q000401:mortality*; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
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