title: Incidence of Sepsis and Mortality With Prior Exposure of HMG-COA Reductase Inhibitors in a Surgical Intensive Care Population.
abstract: The anti-inflammatory properties of hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) may reduce the risk of developing sepsis in surgical intensive care patients and improve outcomes in those who do become septic. The objective of this study was to assess whether surgical intensive care unit (SICU) patients with prior exposure to HMG-CoA reductase inhibitors had a lower incidence of developing sepsis and improved outcomes. A retrospective cohort study was conducted. Patient demographic data, statin use, sequential organ failure assessment (SOFA) scores, vasopressor requirements, ventilator days, length of SICU stay, and mortality in septic patients were collected. Incidence of development of sepsis was determined using systemic inflammatory response syndrome criteria. Patients were grouped into cohorts based on whether they met the sepsis criteria and if they had previously received statins. Cohorts of patients who did and did not become septic with prior statin exposure were compared and an odds ratio was calculated to determine a protective effect. The setting was a SICU. The study comprised of 455 SICU patients and had no interventions. Among the 455 SICU patients, 427 patients were included for the final results. Patients receiving statins verses not receiving statins were similar in demographics. Previous statin exposure had a protective effect in the development of sepsis (9.77% on statins vs. 33.6% without statins; odds ratio 0.203, confidence interval 0.118-0.351). Of those patients who developed sepsis, there was a statistically significant decrease in 28-day mortality in patients with prior statin exposure (P = 0.0341). No statistical difference was noted in length of stay, vasopressor requirements, or days on mechanical ventilation. Prior exposure to statins may have a protective effect on the development of sepsis and decrease mortality in critically ill surgical patients.
authors.affiliation: *Department of Pharmacy Services, Brigham and Women's Hospital, Boston, Massachusetts †St John's University College of Pharmacy and Health Sciences, Queens, New York ‡Department of Surgery, North Shore-LIJ Health System Long Island Jewish Medical Center, New Hyde Park, New York.
authors.forename: James W
authors.initials: JW
authors.lastname: Schurr
authors.forename: Wenchen
authors.initials: W
authors.lastname: Wu
authors.forename: Alexandria
authors.initials: A
authors.lastname: Smith-Hannah
authors.forename: Candace J
authors.initials: CJ
authors.lastname: Smith
authors.forename: Rafael
authors.initials: R
authors.lastname: Barrera
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003422:Critical Care / Q000379:methods; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007362:Intensive Care Units; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D012189:Retrospective Studies; D018805:Sepsis / Q000517:prevention & control*; D018746:Systemic Inflammatory Response Syndrome / Q000517:prevention & control; D014662:Vasoconstrictor Agents / Q000008:administration & dosage
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D014662:Vasoconstrictor Agents