title: Statin therapy and mortality from sepsis: a meta-analysis of randomized trials.
abstract: BACKGROUND
  Statin therapy for sepsis has been suggested by observational studies. However, randomized controlled trials have not demonstrated this benefit. We conducted a systematic review and meta-analysis of randomized trials to evaluate the effect of statin therapy on mortality in patients with sepsis.
  
  
  METHODS
  We searched 6 electronic databases for articles published before August 2014. Randomized trials reporting the effect of statin therapy on mortality in patients with sepsis were included. The primary outcome of interest was in-hospital or 28-day mortality. Two independent reviewers searched and identified studies and extracted data. Risk ratios (RRs) were pooled across studies using random-effects models and were verified using fixed-effects models.
  
  
  RESULTS
  Seven randomized trials were included in the analyses, comprising 1720 patients. Statin therapy did not significantly decrease in-hospital mortality (RR, 1.04; 95% confidence interval, 0.87-1.24; I(2) = 0%; P = .68) or 28-day mortality (RR, 0.93; 95% confidence interval, 0.46-1.89; I(2) = 57%; P = .85) in patients with sepsis. Study quality of the included trials was high; the median Jadad score was 4.5 (range, 4-5).
  
  
  CONCLUSIONS
  This systematic review and meta-analysis of randomized trials suggests that statin therapy does not improve mortality outcomes in patients with sepsis compared with placebo.
authors.affiliation: Medicine Institute Center for Value-Based Care, Cleveland Clinic, Cleveland, Ohio; Department of Infectious Diseases, Medicine Institute, Cleveland Clinic, Cleveland, Ohio; Department of Medicine, Case Western Reserve University, Cleveland, Ohio. Electronic address: abhishekdp@gmail.com.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Deshpande
authors.affiliation: Department of Medicine, Case Western Reserve University, Cleveland, Ohio.
authors.forename: Vinay
authors.initials: V
authors.lastname: Pasupuleti
authors.affiliation: Medicine Institute Center for Value-Based Care, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Rothberg
mesh_terms: D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D018805:Sepsis / Q000401:mortality*; D017211:Treatment Failure
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Meta-analysis; Mortality; Sepsis; Statins