Giuseppe
Emeritus
[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]
Crit Care. 2014 Apr 28;18(2):R83. [Epub ahead of print]
Impact of prior statin therapy on the outcome of patients with suspected ventilator-associated pneumonia: an observational study.
Bruyere R, Vigneron C, Prin S, Pechinot A, Quenot JP, Aho S, Papazian L, Charles PE.
Abstract
INTRODUCTION:
Ventilator associated pneumonia (VAP) is the most commonly acquired infection in intensive care units (ICU). Its outcome is related at least in part to the host's response. Statins have anti-inflammatory effects and may thus improve the outcome. We aimed to assess the impact of prior statin use in the setting of VAP.
METHODS:
A 6-year cohort study was conducted in a French ICU from a teaching hospital. All of the patients with suspected VAP were included. Baseline characteristics, outcomes, statin exposure, and the description of suspected episodes were collected prospectively. The primary endpoint was 30-day mortality. Patients who were taking statins before admission to the ICU whether or not treatment was continued thereafter ("previous users" group) were compared to those without prior statin therapy ("statin naive" group). A survival analysis using a Cox model was conducted in the whole cohort and in the subgroup of prior statin users.
RESULTS:
Among the 349 patients included, 93 (26.6 %) had taken statins. At baseline, these patients were at higher risk of complications than statin naive ones (for example, older, more likely to be men and to have underlying diseases, greater simplified acute physiologic score II (SAPS II)). There was, however, no difference regarding severity at the time VAP was suspected (sequential organ failure assessment (SOFA): 9.0 (4.0 to 16.0) versus 8.0 (4.0 to 17.0); P = 0.11). Nonetheless, 30-day mortality in statin users was not different from that in naive patients (35.5 % versus 26.2 %, respectively; adjusted hazard ratio (HR) = 1.23 (0.79 to 1.90) 95 % confidence interval (CI); P = 0.36). In contrast, after limiting analysis to prior statin users and adjusting for potential confounders, those who continued the treatment had better survival than those who did not (HR = 0.47; (0.22 to 0.97) 95 % CI; P = 0.04).
CONCLUSION:
Statin continuation in prior users could provide protective effects in patients with suspected VAP.
PMID: 24774941 [PubMed - as supplied by publisher]
-
-------
Crit Care. 2014 Apr 28;18(2):R83. [Epub ahead of print]
Impact of prior statin therapy on the outcome of patients with suspected ventilator-associated pneumonia: an observational study.
Bruyere R, Vigneron C, Prin S, Pechinot A, Quenot JP, Aho S, Papazian L, Charles PE.
Abstract
INTRODUCTION:
Ventilator associated pneumonia (VAP) is the most commonly acquired infection in intensive care units (ICU). Its outcome is related at least in part to the host's response. Statins have anti-inflammatory effects and may thus improve the outcome. We aimed to assess the impact of prior statin use in the setting of VAP.
METHODS:
A 6-year cohort study was conducted in a French ICU from a teaching hospital. All of the patients with suspected VAP were included. Baseline characteristics, outcomes, statin exposure, and the description of suspected episodes were collected prospectively. The primary endpoint was 30-day mortality. Patients who were taking statins before admission to the ICU whether or not treatment was continued thereafter ("previous users" group) were compared to those without prior statin therapy ("statin naive" group). A survival analysis using a Cox model was conducted in the whole cohort and in the subgroup of prior statin users.
RESULTS:
Among the 349 patients included, 93 (26.6 %) had taken statins. At baseline, these patients were at higher risk of complications than statin naive ones (for example, older, more likely to be men and to have underlying diseases, greater simplified acute physiologic score II (SAPS II)). There was, however, no difference regarding severity at the time VAP was suspected (sequential organ failure assessment (SOFA): 9.0 (4.0 to 16.0) versus 8.0 (4.0 to 17.0); P = 0.11). Nonetheless, 30-day mortality in statin users was not different from that in naive patients (35.5 % versus 26.2 %, respectively; adjusted hazard ratio (HR) = 1.23 (0.79 to 1.90) 95 % confidence interval (CI); P = 0.36). In contrast, after limiting analysis to prior statin users and adjusting for potential confounders, those who continued the treatment had better survival than those who did not (HR = 0.47; (0.22 to 0.97) 95 % CI; P = 0.04).
CONCLUSION:
Statin continuation in prior users could provide protective effects in patients with suspected VAP.
PMID: 24774941 [PubMed - as supplied by publisher]
-
-------