Statins and outcomes in patients admitted to hospital with community acquired pneumonia: population based prospective cohort study
Statins and outcomes in patients admitted to hospital with community acquired pneumonia: population based prospective cohort study
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DOI：
10.1136/bmj.38992.565972.7c
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发表时间：
2006-11-11
影响因子：
105.7
通讯作者：
Marrie, Thomas J.
中科院分区：
文献类型：
--
作者：
Majumdar, Sumit R.;McAlister, Finlay A.;Marrie, Thomas J.
目的确定他汀类药物是否能降低社区获得性肺炎住院患者的死亡率或重症监护的需要，并评估既往报道的脓毒症相关结局的改善是否是健康使用者效应的结果。加拿大。参与者：因肺炎入院的成年人，根据入院前和住院期间至少一周内他汀类药物的使用情况进行分类。结果3415例肺炎住院患者中，有100例因肺炎住院，100例因肺炎住院，100例因肺炎住院，100例因肺炎住院。624例（18%）死亡或入住重症监护室。他汀类药物使用者死亡或入住重症监护室的可能性低于非使用者（50/325（15%）vs 574/3090（19%），比值比0.80，P = 0.15）。然而，在对混杂因素进行更全面的调整后，比值比从潜在获益（0.78，经年龄和性别调整）变为潜在危害（1.10，经包括倾向评分在内的全面调整）。结论他汀类药物与肺炎患者死亡率降低或需要入住重症监护室无关;脓毒症患者获益的报告可能是混杂因素的结果。
Objectives To determine whether statins reduce mortality or need for admission to intensive care in patients admitted to hospital with community acquired pneumonia, and to assess whether previously reported improvements in sepsis related outcomes were a result of the healthy user effect.Design Population based prospective cohort study.Setting Six hospitals in Capital Health, Edmonton, Alberta, Canada.Participants Adults admitted to hospital with pneumonia and categorised according to use of statins for at least one week before admission and during hospital stay.Main outcome measures Composite of in-hospital mortality or admission to an intensive care unit.Results Of 3415 patients with pneumonia admitted to hospital.. 624 (18%) died or were admitted to an intensive care unit. Statin users were less likely to die or be admitted to an intensive care unit than non-users (50/325 (15%) v 574/3090 (19%), odds ratio 0.80, P = 0.15). After more complete adjustment for confounding, however, the odds ratios changed from potential benefit (0.78, adjusted for age and sex) to potential harm (1.10, fully adjusted including propensity scores. 95% confidence interval 0.76 to 1.60).Conclusions Statins are not associated with reduced mortality or need for admission to an intensive care unit in patients with pneumonia; reports of benefit in the setting of sepsis may be a result of confounding.