title: Statin treatment and mortality: propensity score-matched analyses of 2007-2008 and 2009-2010 laboratory-confirmed influenza hospitalizations.
abstract: Background.  Annual influenza epidemics are responsible for substantial morbidity and mortality. The use of immunomodulatory agents such as statins to target host inflammatory responses in influenza virus infection has been suggested as an adjunct treatment, especially during pandemics, when antiviral quantities are limited or vaccine production can be delayed. Methods.  We used population-based, influenza hospitalization surveillance data, propensity score-matched analysis, and Cox regression to determine whether there was an association between mortality (within 30 days of a positive influenza test) and statin treatment among hospitalized cohorts from 2 influenza seasons (October 1, 2007 to April 30, 2008 and September 1, 2009 to April 31, 2010). Results.  Hazard ratios for death within the 30-day follow-up period were 0.41 (95% confidence interval [CI], .25-.68) for a matched sample from the 2007-2008 season and 0.77 (95% CI, .43-1.36) for a matched sample from the 2009 pandemic. Conclusions.  The analysis suggests a protective effect against death from influenza among patients hospitalized in 2007-2008 but not during the pandemic. Sensitivity analysis indicates the findings for 2007-2008 may be influenced by unmeasured confounders. This analysis does not support using statins as an adjunct treatment for preventing death among persons hospitalized for influenza.
authors.affiliation: Oregon Public Health Division , Oregon Health Authority , Portland.
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Laidler
authors.affiliation: Oregon Public Health Division , Oregon Health Authority , Portland.
authors.forename: Ann
authors.initials: A
authors.lastname: Thomas
authors.affiliation: New Mexico Department of Health, Santa Fe.
authors.forename: Joan
authors.initials: J
authors.lastname: Baumbach
authors.affiliation: California Emerging Infections Program, Oakland.
authors.forename: Pam Daily
authors.initials: PD
authors.lastname: Kirley
authors.affiliation: Connecticut Emerging Infections Program , Yale School of Public Health , New Haven, Connecticut.
authors.forename: James
authors.initials: J
authors.lastname: Meek
authors.affiliation: Colorado Department of Public Health and Environment, Denver.
authors.forename: Deborah
authors.initials: D
authors.lastname: Aragon
authors.affiliation: Minnesota Department of Health, St. Paul.
authors.forename: Craig
authors.initials: C
authors.lastname: Morin
authors.affiliation: Maryland Department of Health and Mental Hygiene, Baltimore.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Ryan
authors.affiliation: Vanderbilt University School of Medicine, Nashville, Tennessee.
authors.forename: William
authors.initials: W
authors.lastname: Schaffner
authors.affiliation: Emerging Infections Program New York State Department of Health, Albany.
authors.forename: Shelley M
authors.initials: SM
authors.lastname: Zansky
authors.affiliation: Influenza Division , Centers for Disease Control and Prevention , Atlanta, Georgia.
authors.forename: Sandra S
authors.initials: SS
authors.lastname: Chaves
keywords: immunomodulatory agents; influenza; influenza mortality; pandemic; pandemic H1N1; statins