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Statin therapy is associated with fewer deaths in patients with bacteraemia
Authors:Peter Kruger  Kenneth Fitzsimmons  David Cook  Mark Jones  Graeme Nimmo
Affiliation:(1) Intensive Care Unit, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, 4102 Brisbane, Queensland, Australia;(2) Department of Anaesthesia, Ipswich Hospital, Australia;(3) Queensland Clinical Trials Centre, University of Queensland, Australia;(4) Division of Microbiology, Queensland Health Pathology Service, Princess Alexandra Hospital, Brisbane, Australia
Abstract:Objective Beneficial effects with statin use are increasingly reported in a variety of patient groups. There is in vitro and clinical evidence for its antiinflammatory and immunomodulatory therapeutic roles. We aimed to assess the association between statin administration and mortality in bacteraemic patients.Design A retrospective cohort analysis.Setting A 300-bed acute general hospital.Patients and participants All patients (n=438) requiring hospital care for an episode of bacteraemia during the years 2000–2003 were included. Statin use, patient outcome, and clinical and laboratory variables were collected.Interventions None.Measurements and results There was a significant reduction in all-cause hospital mortality (10.6% vs. 23.1%, p=0.022) and death attributable to bacteraemia (6.1% vs. 18.3%, p=0.014) in patients who were receiving statin therapy at the time of bacteraemia (n=66). The reduction in all-cause hospital mortality (1.8% vs. 23.1%, p=0.0002) and death attributable to bacteraemia (1.8% vs. 18.3%, p=0.0018) was more pronounced in the patients who continued to receive statin therapy after the diagnosis of bacteraemia (n=56). The apparent mortality benefit persisted after controlling for differences between the groups. Statin use prior to admission was associated with a reduced adjusted hospital mortality rate (odds ratio 0.39; CI 95% 0.17, 0.91; p=0.029), and continuing statin use after bacteraemia increased this effect (odds ratio 0.06; CI 95% 0.01, 0.44; p=0.0056).Conclusion This retrospective study demonstrates a significant survival benefit associated with continuing statin therapy in bacteraemic patients. The potential for statins as an adjuvant therapy in sepsis warrants further investigation.Electronic Supplementary Material Supplementary material is available in the online version of this article at Work was performed at Ipswich Hospital (Ipswich) and Princess Alexandra Hospital (Brisbane), Australia.This article refers to the editorial at .The authors have no financial interest in the products discussed in this paper. The authors have not received sponsorship or funding or have any conflicts of interest.
Keywords:HMG-CoA reductase inhibitor  Statin  Bacteraemia  Mortality
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