Statin therapy prior to ICU admission: protection against infection or a severity marker?

Intensive Care Med. 2006 Jan;32(1):160-4. doi: 10.1007/s00134-005-2743-9. Epub 2005 Aug 16.


Objective: Examine the impact of previous statin therapy on hospital mortality and whether it is due to a protective effect against ICU-acquired infections.

Design and setting: Cohort comparison study by retrospective chart-based analysis in a 26-bed, university-affiliated, medical-surgical ICU.

Patients: We analyzed data from 438 patients at high risk of ICU-acquired infections, i.e., those receiving mechanical ventilation for more than 96 h, 38 (8.7%) of whom had been treated with statins prior to and during ICU admission.

Measurements and results: We recorded clinical characteristics, number and type of ICU-acquired infections, and ICU and hospital mortality. Statin-treated patients were older (71.7+/-8.3 vs. 61.5+/-18.3 years), but differences in predicted mortality risk by APACHE II (39.5+/-24.7 vs. 35.8+/-24.3%) did not reach statistical significance. The ICU-acquired infection rate in statin-treated patients was nonsignificantly lower (29% vs. 38%) and delayed (median 12 vs.10 days), without differences regarding the source of infections. Nevertheless, hospital mortality was significantly higher in statin-treated patients (61% vs. 42%), even after adjustment for APACHE II predicted risk (observed/expected ratio 1.53 vs. 1.17).

Conclusions: Statin therapy is associated with worse outcome, probably because underlying clinical conditions are insufficiently considered in mortality predictors. Its presumed protective effect against ICU infections remains unconfirmed.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cohort Studies
  • Cross Infection / prevention & control*
  • Female
  • Hospital Mortality*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / pharmacology*
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Intensive Care Units* / statistics & numerical data
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Retrospective Studies
  • Risk Assessment


  • Hydroxymethylglutaryl-CoA Reductase Inhibitors