Statin Therapy and Mortality from Sepsis: A Meta-analysis of Randomized Trials
Statin Therapy and Mortality from Sepsis: A Meta-analysis of Randomized Trials
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DOI：
10.1016/j.amjmed.2014.10.057
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发表时间：
2015-04-01
影响因子：
5.9
通讯作者：
Rothberg, Michael B.
中科院分区：
文献类型：
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作者：
Deshpande, Abhishek;Pasupuleti, Vinay;Rothberg, Michael B.
背景：观察性研究建议他汀类药物治疗脓毒症。然而，随机对照试验并没有证明这一益处。为了评价他汀类药物对败血症患者死亡率的影响，我们对随机试验进行了系统回顾和荟萃分析。方法：我们检索了6个电子数据库，检索2014年8月前发表的文章。报告他汀类药物治疗对脓毒症患者死亡率的影响的随机试验包括在内。令人感兴趣的主要结果是住院或28天的死亡率。两名独立的审查员搜索和确定了研究并提取了数据。结果：共纳入7个随机试验，涉及1720名患者。他汀类药物治疗没有显著降低脓毒症患者的住院死亡率(RR，1.04；95%可信区间，0.87-1.24；I-2=0%；P=.68)或28天死亡率(RR，0.93；95%可信区间，0.46-1.89；I-2=57%；P=.85)。纳入试验的研究质量很高；Jadad评分的中位数为4.5(范围4-5)。结论：这项系统回顾和随机试验的荟萃分析表明，与安慰剂相比，他汀类药物并不能改善脓毒症患者的死亡率。(C)2015 Elsevier Inc.保留所有权利。
BACKGROUND: Statin therapy for sepsis has been suggested by observational studies. However, randomized controlled trials have not demonstrated this benefit. We conducted a systematic review and meta-analysis of randomized trials to evaluate the effect of statin therapy on mortality in patients with sepsis.METHODS: We searched 6 electronic databases for articles published before August 2014. Randomized trials reporting the effect of statin therapy on mortality in patients with sepsis were included. The primary outcome of interest was in-hospital or 28-day mortality. Two independent reviewers searched and identified studies and extracted data. Risk ratios (RRs) were pooled across studies using random-effects models and were verified using fixed-effects models.RESULTS: Seven randomized trials were included in the analyses, comprising 1720 patients. Statin therapy did not significantly decrease in-hospital mortality (RR, 1.04; 95% confidence interval, 0.87-1.24; I-2 = 0%; P = .68) or 28-day mortality (RR, 0.93; 95% confidence interval, 0.46-1.89; I-2 = 57%; P = .85) in patients with sepsis. Study quality of the included trials was high; the median Jadad score was 4.5 (range, 4-5).CONCLUSIONS: This systematic review and meta-analysis of randomized trials suggests that statin therapy does not improve mortality outcomes in patients with sepsis compared with placebo. (C) 2015 Elsevier Inc. All rights reserved.