Title |
Association Between Statins Given in Hospital and Mortality in Pneumonia Patients
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Published in |
Journal of General Internal Medicine, August 2011
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DOI | 10.1007/s11606-011-1826-2 |
Pubmed ID | |
Authors |
Michael B. Rothberg, Carol Bigelow, Penelope S. Pekow, Peter K. Lindenauer |
Abstract |
Statins are prescribed to lower cholesterol, but also have anti-inflammatory properties. Some observational studies suggest that statins may reduce mortality from sepsis. Using a highly detailed administrative database, we conducted an observational cohort study of all patients aged ≥18 years who received a discharge diagnosis of pneumonia from 2003-2005 at 376 hospitals. Patients with contraindications to statins, and those unable to take oral medications or discharged within 2 days were excluded. We used multivariable logistic regression and propensity matching to compare mortality among patients who did and did not receive statins on hospital day 1 or 2. Of the 121,254 patients who met the inclusion criteria, median age was 74; 56% were female and 70% were white; 19% received a statin on day 1 or 2. Compared to patients who did not receive statins, statin-treated patients were less likely to be admitted to intensive care (15.7% vs 18.1%, p < 0.001), require mechanical ventilation (6.9% vs. 9.3%, p < 0.001), or die in hospital (3.9% vs 5.7%, p < 0.001). After multivariable adjustment, including the propensity for statin treatment and severity at presentation, mortality was lower in statin-treated patients [OR for propensity-adjusted 0.86 (95% CI 0.79 to 0.93) OR for propensity-matched 0.90, (0.82 to 0.99)]. For patients admitted to intensive care the adjusted odds ratio for mortality with statins was 0.93 (95% CI 0.81 to 1.06), whereas outside intensive care it was 0.79 (95% CI 0.71 to 0.87). Inpatient treatment with statins is associated with a modest reduction in pneumonia mortality outside of intensive care. |
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Geographical breakdown
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Denmark | 1 | 2% |
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Unknown | 62 | 94% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Ph. D. Student | 9 | 14% |
Student > Master | 9 | 14% |
Researcher | 7 | 11% |
Student > Bachelor | 7 | 11% |
Other | 6 | 9% |
Other | 14 | 21% |
Unknown | 14 | 21% |
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---|---|---|
Medicine and Dentistry | 38 | 58% |
Nursing and Health Professions | 3 | 5% |
Agricultural and Biological Sciences | 3 | 5% |
Social Sciences | 3 | 5% |
Environmental Science | 2 | 3% |
Other | 4 | 6% |
Unknown | 13 | 20% |