Statins and outcomes in patients admitted to hospital with community acquired pneumonia: population based prospective cohort study

BMJ. 2006 Nov 11;333(7576):999. doi: 10.1136/bmj.38992.565972.7C. Epub 2006 Oct 23.

Abstract

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.

Publication types

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

MeSH terms

  • Aged
  • Alberta / epidemiology
  • Cohort Studies
  • Community-Acquired Infections / drug therapy*
  • Community-Acquired Infections / mortality
  • Female
  • Healthy Worker Effect
  • Hospital Mortality
  • Hospitalization
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Male
  • Pneumonia, Bacterial / drug therapy*
  • Pneumonia, Bacterial / mortality
  • Prospective Studies
  • Regression Analysis
  • Treatment Outcome

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors