Journal of General Internal Medicine

, Volume 27, Issue 3, pp 280–286

Association Between Statins Given in Hospital and Mortality in Pneumonia Patients

  • Michael B. Rothberg
  • Carol Bigelow
  • Penelope S. Pekow
  • Peter K. Lindenauer
Original Research

DOI: 10.1007/s11606-011-1826-2

Cite this article as:
Rothberg, M.B., Bigelow, C., Pekow, P.S. et al. J GEN INTERN MED (2012) 27: 280. doi:10.1007/s11606-011-1826-2

ABSTRACT

BACKGROUND

Statins are prescribed to lower cholesterol, but also have anti-inflammatory properties. Some observational studies suggest that statins may reduce mortality from sepsis.

METHODS

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.

RESULTS

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).

CONCLUSIONS

Inpatient treatment with statins is associated with a modest reduction in pneumonia mortality outside of intensive care.

KEY WORDS

evidence-based medicinehospital medicinehealth services research

Supplementary material

11606_2011_1826_MOESM1_ESM.doc (130 kb)
Online Appendix: Patient characteristics in the propensity-matched sample (n=44,495) (DOC 130 kb)

Copyright information

© Society of General Internal Medicine 2011

Authors and Affiliations

  • Michael B. Rothberg
    • 1
    • 2
    • 3
  • Carol Bigelow
    • 4
  • Penelope S. Pekow
    • 1
    • 4
  • Peter K. Lindenauer
    • 1
    • 3
  1. 1.Center for Quality of Care ResearchBaystate Medical CenterSpringfieldUSA
  2. 2.Division of General Medicine and GeriatricsBaystate Medical CenterSpringfieldUSA
  3. 3.Tufts University School of MedicineBostonUSA
  4. 4.Division of Biostatistics and EpidemiologyUniversity of MassachusettsAmherstUSA