| Statins and outcomes in patients with bloodstream infection: a propensity-matched analysis. | |
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MedLine Citation:
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PMID: 22202711 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The pleiotropic effects of statins, 3-hydroxy-3 methylglutaryl coenzyme A reductase inhibitor, have been shown to modify inflammatory cell signaling on the immune response to infection. It was postulated that statins may be a good candidate as novel therapeutic agents for the treatment of sepsis. We investigated whether ongoing statin therapy is associated with mortality in patients with bloodstream infection. DESIGN: A retrospective cohort study. SETTING: Two tertiary hospitals in Bronx, NY. PATIENTS: Adult patients in the hospital with bloodstream infection and categorized according to statin therapy as an outpatient or inpatient before bacteremia. INTERVENTIONS: None. MEASUREMENT AND MAIN RESULTS: Of 2,139 bacteremic hospitalized patients, 592 (28%) received statins before blood cultures and 677 (32%) died within 90 days. On multivariate adjustment, the association between statin therapy and 90-day all-cause mortality was statistically significant (hazard ratio, 0.78; 95% confidence interval [CI] 0.65-0.94), but statin users and nonusers differed significantly on many baseline clinical factors. Using the propensity score matched analysis to balance the differences between groups, the association was no longer significant (hazard ratio 0.99; 95% CI 0.77-1.25). Multivariate analysis after stratifying by decile in propensity score for statin use demonstrated similar results (hazard ratio 0.86; 95% CI 0.70-1.06). Statin use was not associated with reduced intensive care unit admission (odds ratio [OR], 0.86; 95% CI 0.59-1.26), hospital length of stay (β = -0.8 days; 95% CI -2.2 to 1.7 days), intensive care unit length of stay (β = -0.1 days; 95% CI -3.7 to 3.8 days), or need for mechanical or noninvasive ventilation (OR 1.03; 95% CI 0.70-1.51). CONCLUSION: After adjusting for the propensity to receive statin therapy, no statistically significant association between statin therapy before bloodstream infection and survival was identified. |
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Authors:
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Sharon Leung; Reha Pokharel; Michelle N Gong |
Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: Critical care medicine Volume: 40 ISSN: 1530-0293 ISO Abbreviation: Crit. Care Med. Publication Date: 2012 Apr |
Date Detail:
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Created Date: 2012-03-19 Completed Date: 2012-05-07 Revised Date: 2013-04-03 |
Medline Journal Info:
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Nlm Unique ID: 0355501 Medline TA: Crit Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 1064-71 Citation Subset: AIM; IM |
Affiliation:
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Division of Critical Care Medicine, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA. sleung@montefiore.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Bacteremia / drug therapy*, mortality Female Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use* Intensive Care / statistics & numerical data Male Middle Aged Propensity Score Proportional Hazards Models Respiration, Artificial / statistics & numerical data Retrospective Studies Statistics, Nonparametric Treatment Outcome |
| Grant Support | |
ID/Acronym/Agency:
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HL084060/HL/NHLBI NIH HHS; HL086667/HL/NHLBI NIH HHS; R01 HL084060-05/HL/NHLBI NIH HHS; R01 HL086667-05/HL/NHLBI NIH HHS; UL1 RR025750/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Hydroxymethylglutaryl-CoA Reductase Inhibitors |
| Comments/Corrections | |
Comment In:
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Crit Care Med. 2012 Apr;40(4):1336-7
[PMID:
22425827
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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