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

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Abstract

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.

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Authors and Affiliations

  1. Critical Care Center, Hospital de Sabadell, Institut Universitari Parc Tauli, Universitat Autonoma de Barcelona, Parc Taulí s/n, 08208, Sabadell, Spain

    Rafael Fernandez & Antonio Artigas

  2. Pharmacy, Hospital de Sabadell, Institut Universitari Parc Tauli, Universitat Autonoma de Barcelona, Parc Taulí s/n, 08208, Sabadell, Spain

    Victor Jose De Pedro

Authors
  1. Rafael Fernandez
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  2. Victor Jose De Pedro
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  3. Antonio Artigas
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Corresponding author

Correspondence to Rafael Fernandez.

Additional information

Financial support was provided by the “Red GIRA” Network of Excellence in Acute Respiratory Failure Research

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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). https://doi.org/10.1007/s00134-005-2743-9

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  • DOI: https://doi.org/10.1007/s00134-005-2743-9

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