tetano
Editor, Senior Moderator
Clin Infect Dis. 2016 May 10. pii: ciw174. [Epub ahead of print]
[h=1]Statin Use and Hospital Length of Stay Among Adults Hospitalized With Community-acquired Pneumonia.[/h] Havers F[SUP]1[/SUP], Bramley AM[SUP]1[/SUP], Finelli L[SUP]1[/SUP], Reed C[SUP]1[/SUP], Self WH[SUP]2[/SUP], Trabue C[SUP]3[/SUP], Fakhran S[SUP]4[/SUP], Balk R[SUP]5[/SUP], Courtney DM[SUP]6[/SUP], Girard TD[SUP]7[/SUP], Anderson EJ[SUP]8[/SUP], Grijalva CG[SUP]2[/SUP], Edwards KM[SUP]2[/SUP], Wunderink RG[SUP]6[/SUP], Jain S[SUP]1[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Prior retrospective studies suggest that statins may benefit patients with community-acquired pneumonia (CAP) due to antiinflammatory and immunomodulatory effects. However, prospective studies of the impact of statins on CAP outcomes are needed. We determined whether statin use was associated with improved outcomes in adults hospitalized with CAP.
[h=4]METHODS:[/h] Adults aged ≥18 years hospitalized with CAP were prospectively enrolled at 3 hospitals in Chicago, Illinois, and 2 hospitals in Nashville, Tennessee, from January 2010-June 2012. Adults receiving statins before and throughout hospitalization (statin users) were compared with those who did not receive statins (nonusers). Proportional subdistribution hazards models were used to examine the association between statin use and hospital length of stay (LOS). In-hospital mortality was a secondary outcome. We also compared groups matched on propensity score.
[h=4]RESULTS:[/h] Of 2016 adults enrolled, 483 (24%) were statin users; 1533 (76%) were nonusers. Statin users were significantly older, had more comorbidities, had more years of education, and were more likely to have health insurance than nonusers. Multivariable regression demonstrated that statin users and nonusers had similar LOS (adjusted hazard ratio
, 0.99; 95% confidence interval [CI], .88-1.12), as did those in the propensity-matched groups (HR, 1.03; 95% CI, .88-1.21). No significant associations were found between statin use and LOS or in-hospital mortality, even when stratified by pneumonia severity.
[h=4]CONCLUSIONS:[/h] In a large prospective study of adults hospitalized with CAP, we found no evidence to suggest that statin use before and during hospitalization improved LOS or in-hospital mortality.
Published by Oxford University Press for the Infectious Diseases Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.
[h=4]KEYWORDS:[/h] hospitalization; hydroxymethylglutaryl-CoA reductase inhibitors; pneumonia; statins
PMID: 27169476 [PubMed - as supplied by publisher]
[h=1]Statin Use and Hospital Length of Stay Among Adults Hospitalized With Community-acquired Pneumonia.[/h] Havers F[SUP]1[/SUP], Bramley AM[SUP]1[/SUP], Finelli L[SUP]1[/SUP], Reed C[SUP]1[/SUP], Self WH[SUP]2[/SUP], Trabue C[SUP]3[/SUP], Fakhran S[SUP]4[/SUP], Balk R[SUP]5[/SUP], Courtney DM[SUP]6[/SUP], Girard TD[SUP]7[/SUP], Anderson EJ[SUP]8[/SUP], Grijalva CG[SUP]2[/SUP], Edwards KM[SUP]2[/SUP], Wunderink RG[SUP]6[/SUP], Jain S[SUP]1[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Prior retrospective studies suggest that statins may benefit patients with community-acquired pneumonia (CAP) due to antiinflammatory and immunomodulatory effects. However, prospective studies of the impact of statins on CAP outcomes are needed. We determined whether statin use was associated with improved outcomes in adults hospitalized with CAP.
[h=4]METHODS:[/h] Adults aged ≥18 years hospitalized with CAP were prospectively enrolled at 3 hospitals in Chicago, Illinois, and 2 hospitals in Nashville, Tennessee, from January 2010-June 2012. Adults receiving statins before and throughout hospitalization (statin users) were compared with those who did not receive statins (nonusers). Proportional subdistribution hazards models were used to examine the association between statin use and hospital length of stay (LOS). In-hospital mortality was a secondary outcome. We also compared groups matched on propensity score.
[h=4]RESULTS:[/h] Of 2016 adults enrolled, 483 (24%) were statin users; 1533 (76%) were nonusers. Statin users were significantly older, had more comorbidities, had more years of education, and were more likely to have health insurance than nonusers. Multivariable regression demonstrated that statin users and nonusers had similar LOS (adjusted hazard ratio
, 0.99; 95% confidence interval [CI], .88-1.12), as did those in the propensity-matched groups (HR, 1.03; 95% CI, .88-1.21). No significant associations were found between statin use and LOS or in-hospital mortality, even when stratified by pneumonia severity.
[h=4]CONCLUSIONS:[/h] In a large prospective study of adults hospitalized with CAP, we found no evidence to suggest that statin use before and during hospitalization improved LOS or in-hospital mortality.
Published by Oxford University Press for the Infectious Diseases Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.
[h=4]KEYWORDS:[/h] hospitalization; hydroxymethylglutaryl-CoA reductase inhibitors; pneumonia; statins
PMID: 27169476 [PubMed - as supplied by publisher]