Document Detail


Prehospital statin and aspirin use and the prevalence of severe sepsis and acute lung injury/acute respiratory distress syndrome.
MedLine Citation:
PMID:  21336116     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To determine whether prehospital statin use is associated with a lower risk of sepsis, acute lung injury/acute respiratory distress syndrome, and mortality in critically ill patients. We also investigated the effect of combined prehospital use of both statins and aspirin.
DESIGN: Cross-sectional analysis of a prospective cohort.
PATIENTS: A total of 575 critically ill patients admitted to the medical or surgical intensive care unit of an academic tertiary-care hospital.
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: Of 575 patients, 149 (26%) were on statin therapy before hospitalization. A multivariable analysis including age, gender, current tobacco use, prehospital aspirin use, race, and Acute Physiology and Chronic Health Evaluation II score revealed that patients on statin therapy before hospitalization were less likely to have or develop severe sepsis (odds ratio 0.62, 95% confidence interval 0.40-0.96) or acute lung injury/acute respiratory distress syndrome (odds ratio 0.60, 95% confidence interval 0.36-0.99) during the first four intensive care unit days. In-hospital mortalities for patients with and without prehospital statin use (odds ratio 1.06, 95% confidence interval 0.62-1.83) were similar. Patients who had prehospital use of both statins and aspirin had the lowest rates of severe sepsis, acute lung injury/acute respiratory distress syndrome, and mortality.
CONCLUSIONS: Prehospital use of statins may be protective against sepsis and acute lung injury. This effect may be potentiated by prehospital aspirin use.
Authors:
Hollis R O'Neal; Tatsuki Koyama; Elizabeth A S Koehler; Edward Siew; Blake R Curtis; Richard D Fremont; Addison K May; Gordon R Bernard; Lorraine B Ware
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Critical care medicine     Volume:  39     ISSN:  1530-0293     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-05-25     Completed Date:  2011-08-11     Revised Date:  2011-09-26    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1343-50     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Section of Pulmonary & Critical Care Medicine, Louisiana State University Health Sciences Center, Baton Rouge, LA, USA. honeal@lsuhsc.edu
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MeSH Terms
Descriptor/Qualifier:
Acute Lung Injury / epidemiology*
Aged
Aspirin / therapeutic use*
Cohort Studies
Cross-Sectional Studies
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
Male
Middle Aged
Platelet Aggregation Inhibitors / therapeutic use*
Prevalence
Respiratory Distress Syndrome, Adult / epidemiology*
Sepsis / epidemiology*
Grant Support
ID/Acronym/Agency:
HL081332/HL/NHLBI NIH HHS; HL103836/HL/NHLBI NIH HHS; K24 HL103836-01/HL/NHLBI NIH HHS; T32 HL 087738/HL/NHLBI NIH HHS; U01 HL081332-04/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 0/Platelet Aggregation Inhibitors; 50-78-2/Aspirin
Comments/Corrections
Comment In:
Crit Care Med. 2011 Jun;39(6):1567-9   [PMID:  21610626 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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