Statin Therapy Is Associated with Decreased Mortality in Patients with Infection
Statin Therapy Is Associated with Decreased Mortality in Patients with Infection
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DOI：
10.1111/j.1553-2712.2009.00350.x
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发表时间：
2009-03-01
影响因子：
4.4
通讯作者：
Shapiro, Nathan I.
中科院分区：
文献类型：
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作者：
Donnino, Michael W.;Cocchi, Michael N.;Shapiro, Nathan I.
目的是调查他汀类药物治疗与急诊科（艾德）疑似感染患者死亡率之间的关系。数据收集于2003年12月至2004年9月。入选标准包括年龄>= 18岁，临床疑似感染和住院。患者分为接受他汀类药物治疗和那些没有接受他汀类药物，而住院。从住院药房数据库中收集药物数据。采用Fisher精确检验或Wilcoxon秩和检验进行比较。为了校正基线差异，进行了多变量logistic回归分析，控制了性别、疾病严重程度（急诊室脓毒症死亡率[MEDS]评分）、Charlson合并症指数和他汀类药物治疗持续时间，在2，132例疑似感染患者中，2，036例（95%）有可解释的药房数据并进行了分析。该队列的中位年龄为61岁（四分位距[IQR] = 46-78岁），死亡率为3.9%（95%置信区间[CI] = 3.1%-4.8%）。接受他汀类药物治疗的患者（n = 474）的未校正粗死亡率（1.9%; 95% CI = 0.6%-3.3%）低于未接受他汀类药物治疗的患者（4.5%; 95% CI = 3.4%-5.4%; p
The objective was to investigate the association between statin therapy and mortality in emergency department (ED) patients with suspected infection.A secondary analysis of a prospective, observational cohort study was conducted at an urban, academic ED with approximately 50,000 annual visits. Data were collected between December 2003 and September 2004. Inclusion criteria consisted of age >= 18 years, clinical suspicion of infection, and hospital admission. Patients were divided by those receiving statin therapy and those not receiving statins while hospitalized. Medication data were collected from an inpatient pharmacy database. Comparisons were conducted with Fisher's exact test or Wilcoxon rank sum test. To adjust for baseline differences, multivariable logistic regression analysis controlling for gender, severity of illness (Mortality in Emergency Department Sepsis [MEDS] score), Charlson Comorbidity Index, and duration of statin therapy was performed.Of 2,132 patients with suspected infection, 2,036 (95%) had interpretable pharmacy data and were analyzed. The cohort had a median age of 61 years (interquartile range [IQR] = 46-78 years) and a mortality of 3.9% (95% confidence interval [CI] = 3.1% to 4.8%). Patients who received statins (n = 474) had a lower unadjusted crude mortality (1.9%; 95% CI = 0.6% to 3.3%) compared to those who did not (4.5%; 95% CI = 3.4% to 5.4%; p