Effect of statin treatment on three-month outcomes in patients with stroke-associated infection: a prospective cohort study

Eur J Neurol. 2012 May;19(5):689-95. doi: 10.1111/j.1468-1331.2011.03608.x. Epub 2011 Dec 19.

Abstract

Background and purpose: Infection is a major medical problem in patients with acute stroke. Recent evidences suggest that statins reduce infection-associated complications. The purpose of this study was to examine the influence of statin treatment on mortality and functional outcomes in patients with stroke-associated infection.

Methods: In this prospective observational cohort study, 514 patients with acute ischaemic stroke or transient ischaemic attack (mean age, 74 ± 11 years; men, 48%) with infection occurring in the first 7 days after admission were included. We examined the effect of in-hospital statin treatment on mortality and favorable functional outcome (modified Rankin Scale score ≤2) at 3 months follow-up.

Results: Infection occurred at 0.93 ± 1.49 days after admission. All patients had not received statin treatment prior to admission, and 121 patients (24%) received statin at 1.71 ± 1.28 days after admission. Follow-up at 3 months was completed for 511 patients (99%). National Institutes of Health Stroke Scale score and Charlson index were the most important independent predictors of mortality and functional outcome. Univariate [hazard ratio (HR), 0.82; 95% confidence intervals (CI), 0.47-1.42] and multivariate (HR, 1.68; 95% CI, 0.79-3.56) Cox regression analysis showed that statin did not significantly decrease the morality. In propensity analysis, statin treatment still had no significant association with mortality (HR, 1.54; 95% CI, 0.68-3.47) in the multivariate analyses after adjusting for age, sex, and propensity score.

Conclusions: Statin use was not associated with a better functional outcome or survival in patients with stroke-associated infection.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anticholesteremic Agents / therapeutic use*
  • Cell Count / methods
  • Cohort Studies
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Infections / drug therapy
  • Infections / etiology*
  • Infections / mortality
  • Kaplan-Meier Estimate
  • Leukocytes / pathology
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Retrospective Studies
  • Stroke / complications*
  • Stroke / drug therapy*
  • Stroke / mortality
  • Time Factors

Substances

  • Anticholesteremic Agents
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors