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Statin Therapy Is Associated with Decreased Mortality in Patients with Infection
Author(s) -
Donnino Michael W.,
Cocchi Michael N.,
Howell Michael,
Clardy Peter,
Talmor Daniel,
Cataldo Lauren,
Chase Maureen,
AlMarshad Adel,
Ngo Long,
Shapiro Nathan I.
Publication year - 2009
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1111/j.1553-2712.2009.00350.x
Subject(s) - medicine , interquartile range , confidence interval , statin , emergency department , odds ratio , comorbidity , retrospective cohort study , logistic regression , cohort , cohort study , emergency medicine , psychiatry
Objectives: The objective was to investigate the association between statin therapy and mortality in emergency department (ED) patients with suspected infection. Methods: 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. Results: 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 ≤ 0.01). When adjusting for gender, MEDS score, Charlson Comorbidity Index, and duration of statin therapy, the odds of death for statin patients was 0.27 (95% CI = 0.1 to 0.72; p ≤ 0.01). Conclusions: Patients who were admitted to the hospital with infection and received statin therapy while hospitalized had a significantly lower in‐hospital mortality compared to patients who did not receive a statin.