Statins and outcomes in patients with bloodstream infection: a propensity-matched analysis.
Statins and outcomes in patients with bloodstream infection: a propensity-matched analysis.
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DOI：
10.1097/ccm.0b013e31823bc9e7
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发表时间：
2012-04
影响因子：
8.8
通讯作者：
Gong MN
中科院分区：
文献类型：
--
作者：
Leung S;Pokharel R;Gong MN
The pleiotropic effects of statins, 3-hydroxy-3 methylglutaryl coenzyme A reductase inhibitor, have been shown to modify inflammatory cell signaling on the immune response to infection. It was postulated that statins may be a good candidate as novel therapeutic agents for the treatment of sepsis. We investigated whether ongoing statin therapy is associated with mortality in patients with bloodstream infection. A retrospective cohort study Two tertiary hospitals in Bronx, New York Adult patients in the hospital with bloodstream infection and categorized according to statin therapy as an outpatient or inpatient prior to bacteremia. None. Of 2139 bacteremic hospitalized patients, 592 (28%) received statins prior to blood cultures and 677 (32%) died within 90-days. On multivariate adjustment, the association between statin therapy and 90-day all-cause mortality was statistically significant (HR 0.78; 95% C.I. 0.65 – 0.94) but statin users and non-users differed significantly on many baseline clinical factors. Using the propensity score matched analysis to balance the differences between groups, the association was no longer significant (HR 0.99, 95% CI 0.77 – 1.25). Multivariate analysis after stratifying by decile in propensity score for statin use demonstrated similar results (HR 0.86; 95% CI 0.70 – 1.06). Statin use was not associated with reduced ICU admission (OR 0.86; 95% CI 0.59 – 1.26), hospital LOS (β = −0.8 days, 95% CI −2.2 – 1.7 days), ICU LOS (β = −0.1 days, 95% CI −3.7 – 3.8 days), or need for mechanical or non-invasive ventilation (OR 1.03; 95% CI 0.70 – 1.51). After adjusting for the propensity to receive statin therapy, no statistically significant association between statin therapy prior to bloodstream infection and survival was identified.
