Statin therapy in patients admitted to hospital with presumed infection

Introduction

Several studies, largely retrospective, have suggested improved outcomes and a reduction in inflammatory response in patients who develop infection whilst on statin therapy. This study reports outcomes for patients on established statin therapy admitted to hospital with presumed infection compared with those patients not on a statin.

Methods

The study was approved by the Princess Alexandra Hospital Research Ethics Committee and conducted from May 2006 to October 2008 as part of a randomised controlled study investigating continuing established statin therapy. A daily computer-generated report identified all patients admitted to hospital with a potential diagnosis of infection.

Results

From a total of 2,291 patients screened, 2,239 were considered to have presumed infection. Of these, 2,161 were aged >30 years and were included in the final analysis (statin users = 633, no statin use = 1,528). The statin group was significantly older with a mean age (± SD) of 69 ± 12 versus 61 ± 16 years (P = 0.0001) and included more men (62.1% vs. 55.2%, P = 0.004). The source of presumed infection was not statistically different between the groups (overall chi-square P = 0.16). A presumed respiratory source was the most common in both groups (statin 35.5% vs. no statin 37.1%, respectively) followed by skin (19.0 vs. 20.3%), gastrointestinal (17.8 vs. 14.1%), urosepsis (13.0 vs. 11.7%) and other sources (14.7 vs. 16.8%). Two or more SIRS criteria was seen in 65.4% of the statin group patients and 67.8% of the no statin group (P = 0.30). Hospital mortality was similar in both groups (7.4% statin group and 6.5% no statin group, P = 0.64), as was the rate of ICU admission (17% statin group and 16% no statin group; P = 0.63). Hospital length of stay was not significantly different between the groups (11.4 ± 15.4 days in the statin group and 12.5 ± 26.2 days in the no statin group, P = 0.10).

Conclusion

In a heterogeneous cohort of patients admitted to hospital with presumed infection, prior statin therapy was not associated with an improved outcome or reduced systemic inflammatory response. The age and gender differences observed are in keeping with previous literature and support the assertion that statin users represent a different patient group to those not using statin therapy.