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Association Between Statins Given in Hospital and Mortality in Pneumonia Patients

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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.

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Funding

The authors are indebted to an anonymous physician for partially funding this study with personal funds. The donor had no other role in the study

Prior presentations

These data have not been presented previously.

The authors are also indebted to Dr. David Fedson for help in defining the study question, obtaining funding, and background research.

Conflict of Interest

None disclosed.

Author information

Authors and Affiliations

  1. Center for Quality of Care Research, Baystate Medical Center, Springfield, MA, USA

    Michael B. Rothberg MD, MPH, Penelope S. Pekow PhD & Peter K. Lindenauer MD, MSc

  2. Division of General Medicine and Geriatrics, Baystate Medical Center, 759 Chestnut Street, Springfield, MA, 01199, USA

    Michael B. Rothberg MD, MPH

  3. Tufts University School of Medicine, Boston, MA, USA

    Michael B. Rothberg MD, MPH & Peter K. Lindenauer MD, MSc

  4. Division of Biostatistics and Epidemiology, University of Massachusetts, Amherst, MA, USA

    Carol Bigelow PhD & Penelope S. Pekow PhD

Authors
  1. Michael B. Rothberg MD, MPH
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  2. Carol Bigelow PhD
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  3. Penelope S. Pekow PhD
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  4. Peter K. Lindenauer MD, MSc
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Corresponding author

Correspondence to Michael B. Rothberg MD, MPH.

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Rothberg, M.B., Bigelow, C., Pekow, P.S. et al. Association Between Statins Given in Hospital and Mortality in Pneumonia Patients. J GEN INTERN MED 27, 280–286 (2012). https://doi.org/10.1007/s11606-011-1826-2

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  • DOI: https://doi.org/10.1007/s11606-011-1826-2

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