Prehospital statin and aspirin use and the prevalence of severe sepsis and acute lung injury/acute respiratory distress syndrome.
Prehospital statin and aspirin use and the prevalence of severe sepsis and acute lung injury/acute respiratory distress syndrome.
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院前他汀类药物和阿司匹林使用以及严重败血症和急性肺损伤/急性呼吸窘迫综合征的患病率。
DOI：
10.1097/ccm.0b013e3182120992
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发表时间：
2011-06
影响因子：
8.8
通讯作者：
Ware LB
中科院分区：
文献类型：
--
作者：
O'Neal HR Jr;Koyama T;Koehler EA;Siew E;Curtis BR;Fremont RD;May AK;Bernard GR;Ware LB
确定院前使用他汀类药物是否与危重患者败血症、ALI/ARDS和死亡率的风险降低相关。我们还调查了院前联合使用他汀类药物和阿司匹林的效果。对一家三级医院内科或外科ICU收治的575例重症患者的前瞻性队列的横断面分析在575例患者中，149例（26%）在住院前接受他汀类药物治疗。一项多变量分析包括年龄、性别、目前吸烟情况、院前阿司匹林使用情况、种族和APACHE II评分，结果显示，住院前接受他汀类药物治疗的患者在ICU的前4天发生或发展为严重脓毒症（OR 0.62，95% CI 0.40 - 0.96）或ALI/ARDS（OR 0.60，95% CI 0.36 - 0.99）的可能性较低。入院前使用和未使用他汀类药物患者的院内死亡率（OR 1.06，95%CI 0.62 - 1.83）相似。院前同时使用他汀类药物和阿司匹林的患者严重脓毒症、ALI/ARDS和死亡率最低。院前使用他汀类药物可能对脓毒症和ALI具有保护作用。这种作用可能会加强院前阿司匹林的使用。
To determine if prehospital statin use is associated with a lower risk of sepsis, ALI/ARDS, and mortality in critically ill patients. We also investigated the effect of combined prehospital use of both statins and aspirin. Cross-sectional analysis of a prospective cohort 575 critically ill patients admitted to the medical or surgical ICU of an academic tertiary-care hospital Of 575 patients, 149 (26%) were on statin therapy prior to hospitalization. A multivariable analysis including age, gender, current tobacco use, prehospital aspirin use, race, and APACHE II score revealed that patients on statin therapy prior to hospitalization were less likely to have or develop severe sepsis (OR 0.62, 95% CI 0.40 to 0.96) or ALI/ARDS (OR 0.60, 95% CI 0.36 to 0.99) during the first four ICU days. In-hospital mortality for patients with and without prehospital statin use (OR 1.06, 95% CI 0.62 to 1.83) was similar. Patients who had prehospital use of both statins and aspirin had the lowest rates of severe sepsis, ALI/ARDS and mortality. Prehospital use of statins may be protective against the sepsis and ALI. This effect may be potentiated by prehospital aspirin use.