Document Detail


The association of prior statin use in septic shock treated with early goal directed therapy.
MedLine Citation:
PMID:  21915053     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Previous literature suggests statins may have a therapeutic role in sepsis. No data have examined if statin use may have a positive impact beyond that afforded by early goal directed therapy (EGDT).
OBJECTIVE: To test the hypothesis that previous statin use is associated with improved clinically relevant outcomes in patients with severe sepsis and septic shock receiving EGDT.
METHODS: Retrospective cohort study of 91 patients who presented in an academic center in severe sepsis or septic shock and received EGDT. Primary outcome was mortality and secondary outcomes included mechanical ventilation days, ICU length of stay, and hospital length of stay.
RESULTS: Patients (87 of 91) presented to the Emergency Department before ICU admission. Patients (18 of 91) were receiving statin therapy before presentation. The statin group had a mortality rate of 22.2 vs. 39.7% in the nonstatin group (P=0.273). The statin group had fewer mechanical ventilation days (8.49 vs. 7.29 days, P=0.026), and a trend in improved hospital length of stay (17.9 vs. 14.4 days, P=0.065), and ICU length of stay (7.15 vs. 4.89 days, P=0.077).
CONCLUSION: Prior statin use is associated with fewer mechanical ventilation days and a trend toward improvement in other clinically relevant outcomes. This trial is limited by its retrospective nature and small sample size. These results should serve as hypothesis generating for future prospective trials, as the lack of novel drug therapy and the mortality rate of septic shock both remain unacceptable.
Authors:
Brian M Fuller; Mithil Gajera; Christa Schorr; David Gerber; R Phillip Dellinger; Sergio Zanotti
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of emergency medicine : official journal of the European Society for Emergency Medicine     Volume:  19     ISSN:  1473-5695     ISO Abbreviation:  Eur J Emerg Med     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-06-26     Completed Date:  2012-11-01     Revised Date:  2013-08-16    
Medline Journal Info:
Nlm Unique ID:  9442482     Medline TA:  Eur J Emerg Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  226-30     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, Division of Critical Care Medicine, Washington University School of Medicine, St. Louis, Missouri 63110, USA. fullerb@wusm.wustl.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents / administration & dosage*,  therapeutic use
Chi-Square Distribution
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors / adverse effects*
Length of Stay
Male
Middle Aged
Mortality
Retrospective Studies
Shock, Septic / chemically induced*,  drug therapy,  etiology
Statistics as Topic
Time Factors
Grant Support
ID/Acronym/Agency:
UL1 RR024992/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors
Comments/Corrections

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