title: The association between prior statin use and long-term outcomes after critical care admission.
abstract: Statins may have immunomodulatory effects that benefit critically ill patients. Therefore, we retrospectively examined the association between survival and the prescription of statins prior to admission to an intensive care unit (ICU), or high dependency unit (HDU), as a result of major elective surgery or as an emergency with a presumed diagnosis of sepsis.
  
  
  
  We retrospectively studied critical care patients (ICU or HDU) from a tertiary referral UK teaching hospital. Nottingham University Hospitals have more than 2200 beds, of which 39 are critical care beds. Over a 5-year period (2000-2005), 414 patients were identified with a presumed diagnosis of sepsis, and 672 patients were identified who had planned ICU/HDU admissions following elective major surgery. Patients prescribed statins prior to hospital admission were compared with those who were not. Demographics, medical history, drug history, and Acute Physiology and Chronic Health Evaluation II scores were examined. Univariate and multivariate analyses were applied using the primary end point of survival at 5 years after admission.
  
  
  
  Patients prescribed statins prior to critical care admission were, on average, older and had higher initial Acute Physiology and Chronic Health Evaluation II scores and more preexisting comorbidities. Statins were almost invariably stopped following admission to critical care. Statin use was not associated with significantly altered survival during hospital admission, or at 5 years, for either patients with sepsis (9% vs 15%, P=.121; 73% vs 84%, P=.503, respectively) or postoperative patients (55% vs 58%, P=.762; 57% vs 63%, P=.390).
  
  
  
  Prior statin use was not associated with improved outcomes in patients admitted to critical care after elective surgical cases or with a presumed diagnosis of sepsis.
authors.affiliation: University Department of Anaesthesia and Intensive Care, City Campus, Nottingham University Hospital, NG5 1PB, UK. Electronic address: martin.beed@nottingham.ac.uk.
authors.forename: M
authors.initials: M
authors.lastname: Beed
authors.affiliation: University of Alberta Hospital, Edmonton, Alberta, Canada.
authors.forename: P G
authors.initials: PG
authors.lastname: Brindley
authors.affiliation: University Department of Anaesthesia and Intensive Care, City Campus, Nottingham University Hospital, NG5 1PB, UK.
authors.forename: R
authors.initials: R
authors.lastname: Mahajan
authors.affiliation: Centre for Integrated Systems Biology in Medicine, Nottingham University Medical School, Nottingham, NG7 2UH, UK.
authors.forename: I
authors.initials: I
authors.lastname: Juttner
authors.affiliation: Centre for Integrated Systems Biology in Medicine, Nottingham University Medical School, Nottingham, NG7 2UH, UK.
authors.forename: J
authors.initials: J
authors.lastname: Campion-Smith
authors.affiliation: Centre for Integrated Systems Biology in Medicine, Nottingham University Medical School, Nottingham, NG7 2UH, UK.
authors.forename: V G
authors.initials: VG
authors.lastname: Wilson
mesh_terms: D018806:APACHE; D000368:Aged; D015897:Comorbidity; D003422:Critical Care; D004334:Drug Administration Schedule; D004739:England; D005260:Female; D006785:Hospitals, University; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010343:Patient Admission; D012189:Retrospective Studies; D018805:Sepsis / Q000401:mortality*; D016019:Survival Analysis; D062606:Tertiary Care Centers
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Critical care; Hydroxymethylglutaryl-CoA reductase inhibitors; Postoperative complications; Sepsis