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Eur J Clin Microbiol Infect Dis. 2019 Aug 28. doi: 10.1007/s10096-019-03684-y. [Epub ahead of print]
Statins and outcomes of hospitalized patients with laboratory-confirmed 2017-2018 influenza.
Atamna A1,2, Babitch T3,4, Bracha M3, Sorek N5, Haim BZ5, Elis A3,6, Bishara J7,3, Avni T3,4.
Author information
1 Infectious Disease Unit, Rabin Medical Center, Beilinson Hospital, 49100, Petah Tikva, Israel. a.atamna86@gmail.com. 2 Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. a.atamna86@gmail.com. 3 Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 4 Internal Medicine Department E, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel. 5 Clinical Microbiology Laboratory, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel. 6 Internal Medicine Department C, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel. 7 Infectious Disease Unit, Rabin Medical Center, Beilinson Hospital, 49100, Petah Tikva, Israel.
Abstract
No studies evaluating the association between statins and outcomes of patients with seasonal influenza have been performed since the 2007-2008 and the 2009 pandemic H1N1 influenza seasons. All consecutive hospitalized patients between October 2017 and April 2018, diagnosed with laboratory-confirmed influenza A and B virus, were included. Patients were divided into two groups: statin and non-statin users. Outcomes were 30- and 90-day mortality, complications (pneumonia, myocarditis, encephalitis, intensive care unit (ICU) transfer, mechanical ventilation, vasopressor support), length of hospital stay, and readmission rates. A multivariate analysis was performed to adjust for mortality risk factors. To compare the groups, we matched patients to the nearest neighbor propensity score. Of the 526 patients ill with influenza A (201/526) and B (325/526), 36% (188/526) were statin users; 64% (338/526) were not. Statin users were older (78 vs.70; p = < 0.05) and suffered from more comorbidities (Charlson comorbidity scores of 6 vs.4; p < 0.005). The 30-day mortality rate among statin vs. non-statin users was 6% vs. 8% (p = 0.3). On multivariate analysis, statin use was not associated with mortality benefit (OR = 0.67 (0.29-1.36)). After propensity score matching, the results were unchanged (OR = 0.71 (0.29-1.71)). Statin users were diagnosed with less complicated diseases as they were less likely to receive vasopressor support, mechanical ventilation, and/or transfer to the ICU. Although statin users were significantly older and exhibited more comorbidities, 30-day mortality rates did not differ between statin users and non-users, which may signify a protective role of statins on seasonal influenza patients. Further studies performed during different influenza seasons and different subtypes are essential.
KEYWORDS:
Influenza; Mortality; Outcomes; Statins
PMID: 31463620 DOI: 10.1007/s10096-019-03684-y
Statins and outcomes of hospitalized patients with laboratory-confirmed 2017-2018 influenza.
Atamna A1,2, Babitch T3,4, Bracha M3, Sorek N5, Haim BZ5, Elis A3,6, Bishara J7,3, Avni T3,4.
Author information
1 Infectious Disease Unit, Rabin Medical Center, Beilinson Hospital, 49100, Petah Tikva, Israel. a.atamna86@gmail.com. 2 Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. a.atamna86@gmail.com. 3 Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 4 Internal Medicine Department E, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel. 5 Clinical Microbiology Laboratory, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel. 6 Internal Medicine Department C, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel. 7 Infectious Disease Unit, Rabin Medical Center, Beilinson Hospital, 49100, Petah Tikva, Israel.
Abstract
No studies evaluating the association between statins and outcomes of patients with seasonal influenza have been performed since the 2007-2008 and the 2009 pandemic H1N1 influenza seasons. All consecutive hospitalized patients between October 2017 and April 2018, diagnosed with laboratory-confirmed influenza A and B virus, were included. Patients were divided into two groups: statin and non-statin users. Outcomes were 30- and 90-day mortality, complications (pneumonia, myocarditis, encephalitis, intensive care unit (ICU) transfer, mechanical ventilation, vasopressor support), length of hospital stay, and readmission rates. A multivariate analysis was performed to adjust for mortality risk factors. To compare the groups, we matched patients to the nearest neighbor propensity score. Of the 526 patients ill with influenza A (201/526) and B (325/526), 36% (188/526) were statin users; 64% (338/526) were not. Statin users were older (78 vs.70; p = < 0.05) and suffered from more comorbidities (Charlson comorbidity scores of 6 vs.4; p < 0.005). The 30-day mortality rate among statin vs. non-statin users was 6% vs. 8% (p = 0.3). On multivariate analysis, statin use was not associated with mortality benefit (OR = 0.67 (0.29-1.36)). After propensity score matching, the results were unchanged (OR = 0.71 (0.29-1.71)). Statin users were diagnosed with less complicated diseases as they were less likely to receive vasopressor support, mechanical ventilation, and/or transfer to the ICU. Although statin users were significantly older and exhibited more comorbidities, 30-day mortality rates did not differ between statin users and non-users, which may signify a protective role of statins on seasonal influenza patients. Further studies performed during different influenza seasons and different subtypes are essential.
KEYWORDS:
Influenza; Mortality; Outcomes; Statins
PMID: 31463620 DOI: 10.1007/s10096-019-03684-y