title: Prior statin use and the outcomes in patients with first-attack acute pancreatitis: A retrospective cohort study.
abstract: BACKGROUND
  We investigated whether prior stain use before admission for a first-attack AP would reduce the severity and mortality rate of a first-attack of AP with a dose-response relationship.
  
  
  METHODS
  We conducted a retrospective cohort study from a tertiary medical center's database in Taiwan. We evaluated the dose-response relationship between statin use and the first-attack of AP by defining the daily dose (DDD). The cumulative DDD (cDDD) was calculated as the sum of the dispensed DDD of any specific statin. The outcome measures in our study included the hospital mortality rate, duration of hospitalization, Ranson's score, computed tomography severity index (CTSI), and C-reactive protein (CRP) level.
  
  
  RESULTS
  In our study, we enrolled 31 patients in statin group and 63 matched patients in control group. In the univariate analysis there was no significant difference between them with regard to the outcomes except the CTSI and serum calcium concentration. According to multivariate analysis the serum calcium concentration was significantly higher in the statin group, and the CTSI was lower in the statin group. In subgroup analysis we divided the statin group into two groups according to the cDDDs (<365days and >365days) and the results showed no significance in the demographic data, overall mortality rate, hospitalization days, CRP level, Ranson's score, or CTSI.
  
  
  CONCLUSIONS
  Our study rejected the hypothesis that statins have beneficial effects on the clinical outcomes of patients with a first-attack of AP. However we demonstrated that statins have a positive effect on the CTSI.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.
authors.forename: Sz-Iuan
authors.initials: SI
authors.lastname: Shiu
authors.affiliation: Department of Statistics, National Cheng-kung University, Tainan, Taiwan, ROC.
authors.forename: Pei-Fang
authors.initials: PF
authors.lastname: Su
authors.affiliation: Intensive Care Unit, Dachien Hospital, Miaoli, Taiwan, ROC.
authors.forename: Li-Ho
authors.initials: LH
authors.lastname: Jang
authors.affiliation: Department of Critical Care Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.
authors.forename: Bor-Jen
authors.initials: BJ
authors.lastname: Lee
authors.affiliation: Department of Critical Care Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, ROC. Electronic address: chestmen@gmail.com.
authors.forename: Chen-Yu
authors.initials: CY
authors.lastname: Wang
mesh_terms: D000208:Acute Disease; D000328:Adult; D016022:Case-Control Studies; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D010195:Pancreatitis / Q000401:mortality / Q000517:prevention & control*; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Acute necrotizing; HMG-CoA; Pancreatitis; Retrospective studies; Statins