title: Statin Use and Hospital Length of Stay Among Adults Hospitalized With Community-acquired Pneumonia.
abstract: Prior retrospective studies suggest that statins may benefit patients with community-acquired pneumonia (CAP) due to antiinflammatory and immunomodulatory effects. However, prospective studies of the impact of statins on CAP outcomes are needed. We determined whether statin use was associated with improved outcomes in adults hospitalized with CAP.
  
  
  
  Adults aged ≥18 years hospitalized with CAP were prospectively enrolled at 3 hospitals in Chicago, Illinois, and 2 hospitals in Nashville, Tennessee, from January 2010-June 2012. Adults receiving statins before and throughout hospitalization (statin users) were compared with those who did not receive statins (nonusers). Proportional subdistribution hazards models were used to examine the association between statin use and hospital length of stay (LOS). In-hospital mortality was a secondary outcome. We also compared groups matched on propensity score.
  
  
  
  Of 2016 adults enrolled, 483 (24%) were statin users; 1533 (76%) were nonusers. Statin users were significantly older, had more comorbidities, had more years of education, and were more likely to have health insurance than nonusers. Multivariable regression demonstrated that statin users and nonusers had similar LOS (adjusted hazard ratio [HR], 0.99; 95% confidence interval [CI], .88-1.12), as did those in the propensity-matched groups (HR, 1.03; 95% CI, .88-1.21). No significant associations were found between statin use and LOS or in-hospital mortality, even when stratified by pneumonia severity.
  
  
  
  In a large prospective study of adults hospitalized with CAP, we found no evidence to suggest that statin use before and during hospitalization improved LOS or in-hospital mortality.
authors.affiliation: Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Fiona
authors.initials: F
authors.lastname: Havers
authors.affiliation: Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Bramley
authors.affiliation: Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Lyn
authors.initials: L
authors.lastname: Finelli
authors.affiliation: Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Carrie
authors.initials: C
authors.lastname: Reed
authors.affiliation: Vanderbilt University School of Medicine.
authors.forename: Wesley H
authors.initials: WH
authors.lastname: Self
authors.affiliation: University of Tennessee Health Sciences Center, Saint Thomas Health, Nashville.
authors.forename: Christopher
authors.initials: C
authors.lastname: Trabue
authors.affiliation: John H. Stroger, Jr Hospital of Cook County.
authors.forename: Sherene
authors.initials: S
authors.lastname: Fakhran
authors.affiliation: Rush University Medical Center.
authors.forename: Robert
authors.initials: R
authors.lastname: Balk
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: D Mark
authors.initials: DM
authors.lastname: Courtney
authors.affiliation: Vanderbilt University School of Medicine.|Department of Veterans Affairs Medical Center, Nashville, Tennessee.
authors.forename: Timothy D
authors.initials: TD
authors.lastname: Girard
authors.affiliation: Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Evan J
authors.initials: EJ
authors.lastname: Anderson
authors.affiliation: Vanderbilt University School of Medicine.
authors.forename: Carlos G
authors.initials: CG
authors.lastname: Grijalva
authors.affiliation: Vanderbilt University School of Medicine.
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Edwards
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Richard G
authors.initials: RG
authors.lastname: Wunderink
authors.affiliation: Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Seema
authors.initials: S
authors.lastname: Jain
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000517:prevention & control; D017714:Community-Acquired Infections / Q000453:epidemiology*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011014:Pneumonia / Q000453:epidemiology*; D057216:Propensity Score; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: hospitalization; hydroxymethylglutaryl-CoA reductase inhibitors; pneumonia; statins