Abstract
Sepsis is a common pathology in Intensive Care Units (ICU). At its most acute phase, namely septic shock, mortality rates can be as high as 60%. Early administration of antibiotics is known to be crucial for ICU outcomes. In particular, statins, a class of drug usually associated to the regulation of the biosynthesis of cholesterol, have been shown to present good anti-inflammatory properties. In this brief study, we hypothesized that the pre-admission use of statins should improve ICU outcomes, reducing the mortality rate. We tested this hypothesis in a prospective study with patients admitted with severe sepsis and multi-organ failure at the ICU of Vall d’Hebrón University Hospital (Barcelona, Spain). Outcome was predicted using statistic algebraic models and the Bayesian Networks that can naturally be derived from these models.
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References
Livingston, D.H., Mosenthal, A.C., Deith, E.A.: Sepsis and multiple organ dysfunction syndrome: A clinical-mechanistic overview. New Horizons 3, 257–266 (1995)
American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference, Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit. Care Med. 20, 864–874 (1992)
Levy, M.M., Fink, M.P., Marshall, J.C., Edward Angus, A., Cook, D., Cohen, J., Opal, S.M., Vincent, J.L., Ramsay, G.: 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Intensive Care Med. 29, 530–538 (2003)
Esteban, A., Frutos-Vivar, F., Ferguson, N., Penuelas, O., Lorente, J., Al, G.F., Honrubia, T., Algora, A., Bustos, A., Garcia, G., Rodriguez, I., Ruiz, R.: Sepsis incidence and outcome: contrasting the intensive care unit with the hospital ward. Crit. Care Med. 35(5), 1284–1289 (2007)
Angus, D.C., Linde-Zwirble, W.T., Lidicker, J., Clermont, G.L., Carcillo, J., Pinski, M.R.: Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit. Care Med. 29(7), 1303–1310 (2001)
Martin, G.S., Mannino, D.M., Eaton, S., Ross, M.: The epidemiology of sepsis in the United States from 1979 through 2000. N. Eng. J. Med. 348(16), 1546–1554 (2003)
Almog, Y., Novack, V., Eisinger, M., Porath, A., Novack, L., Gilutz, H.: The effect of statin therapy on infection-related mortality in patients with atherosclerotic diseases. Crit. Care Med. 35, 372–378 (2007)
Chopra, V., Flanders, S.A.: Does Statin Use Improve Pneumonia Outcomes? Chest 136, 1381–1388 (2009)
Gao, F., Linhartova, L., Johnston, M., Thickett, D.R.: Statins and sepsis. Br J. Anaesth 100, 288–298 (2008)
Thomsen, R.W., Hundborg, H.H., Johnsen, S.P.J., Pedersen, L., Sorensen, H.T., Schonheyder, H.C., Lervang, H.H.: Statin use and mortality within 180 days after bacteremia: A population-based cohort study. Crit. Care Med. 34, 1080–1086 (2006)
Tleyjeh, I.M., Kashour, T., Hakim, F.A., Zimmerman, V.A., Erwin, P.J., Sutton, A.J., Ibrahim, T.: Statins for the prevention and treatment of infections. A systematic review and meta-analysis. Arch. Intern. Med. 169, 1658–1667 (2009)
Christensen, S., Thomsen, R.W., Johansen, M.B., Pedersen, L., Jensen, R., Larsen, K.M., Larsson, A., Tonnesen, E., Sorensen, H.T.: Preadmission statin use and one-year mortality among patients in intensive care. A cohort study. Crit. Care 14, 29 (2010)
Schmidt, H., Hennen, R., Keller, A., Russ, M., Muller-Werdan, U., Werdan, K., Buerke, M.: Association of statin therapy and increased survival in patients with multiple organ dysfunction syndrome. Intensive Care Med. 32, 1248–1251 (2006)
Majumdar, S.R., McAlister, F.A., Eurich, D.T., Padwal, R.S., Marrie, T.J.: Statins and outcomes in patients admitted to hospital with community acquired pneumonia: population based prospective cohort study. BMJ 333(7576), 999–1001 (2006)
Kapoor, A.S., Kanji, H., Buckingham, J., Devereaux, P.J., McAlister, F.A.: Strength of evidence for perioperative use of statins to reduce cardiovascular risk: systematic review of controlled studies. BMJ 333, 1149 (2006)
Fernandez, R., De Pedro, V.J., Artigas, A.: Statin therapy prior to ICU admission: protection against infection or a severity marker? Intensive Care Med. 32, 160–164 (2006)
Bellazzi, R., Zupan, B.: Predictive data mining in clinical medicine: Current issues and guidelines. International Journal of Medical Informatics 77, 81–97 (2008)
Vincent, J.L., Moreno, R., Takala, J., Willats, S., De Mendoça, A., Bruining, H., Reinhart, C.K., Suter, P.M., Thijs, L.G.: The SOFA (Sepsis Related Organ Failure Assessment) Score to describe organ dysfunction/failure. Intensive Care Med. 22, 707–710 (1996)
Knaus, W.A., Draper, E.A., Wagner, D.P., Zimmerman, J.E.: APACHE II: A severity of disease classification system. Crit. Care Med. 13, 818–829 (1985)
Lopes Ferreira, F., Peres Bota, D., Bross, A., Melot, C., Vincent, J.L.: Serial Evaluation of the SOFA Score to Predict Outcome in Critically Ill Patients. JAMA 286, 1754–1758 (2001)
Pachter, M., Sturmfels, B.: Algebraic Statistics for Computational Biology. Cambridge University Press (2005)
Pistone, G., Riccomagno, E., Wynn, H.P.: Algebraic Statistics: Computational Commutative Algebra in Statistics. Chapman and Hall, CRC Press (2001)
Lauritzen, S.: Graphical Models. Oxford University Press (1996)
Geiger, D., Meek, C., Sturmfels, B.: On the Toric Algebra of Graphical Models. Ann. Statist. 34(3), 1463–1492 (2006)
Hammersley, J.M., Clifford P.: Markov Fields on Finite Graphs and Lattices (1971) (unpublished manuscript), http://www.statslab.cam.ac.uk/~grg/books/hammfest/hamm-cliff.pdf
Hastie, T., Tibshirani, R., Friedman, J.: The Elements of Statistical Learning: Data Mining, Inference, and Prediction, 2nd edn. Springer Series in Statistics. Springer (2009)
Breiman, L., Friedman, J., Stone, C.J.: Classification and Regression Trees. Chapman and Hall/CRC (1984)
Golub, G.H., Reinsch, C.: Singular value decomposition and least squares solutions. Numer. Math. 14(5), 403–420 (1970)
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Ribas, V.J. et al. (2012). On the Use of Graphical Models to Study ICU Outcome Prediction in Septic Patients Treated with Statins. In: Biganzoli, E., Vellido, A., Ambrogi, F., Tagliaferri, R. (eds) Computational Intelligence Methods for Bioinformatics and Biostatistics. CIBB 2011. Lecture Notes in Computer Science(), vol 7548. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-35686-5_9
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DOI: https://doi.org/10.1007/978-3-642-35686-5_9
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