Preadmission statin use improves the outcome of less severe sepsis patients - A population-based propensity score matched cohort study

National Taiwan University Hospital Health Economics and Outcome Research Group

研究成果: 雜誌貢獻文章

5 引文 斯高帕斯(Scopus)

摘要

Background Randomized controlled trials on the post-admission use of statins in sepsis patients have not shown a survival benefit. Whether preadmission use of statins would confer any beneficial effects in sepsis patients has not been well studied. Methods We conducted a population-based cohort study on a national health insurance claims database between 1999 and 2011. Sepsis patients were identified by ICD-9 codes compatible with the third International consensus definitions for sepsis. Use of statin was defined as the cumulative use of any statin for more than 30 days before the indexed sepsis admission. We determined the association between statin use and sepsis outcome by multivariate-adjusted Cox proportional hazard models and propensity score matched analysis. To minimize baseline imbalance between statin users and non-statin users, we matched/adjusted for social economic status, comorbidities, proxies for healthy lifestyle, health care facility utilization, and use of medications. Results We identified 52 737 sepsis patients, of which 3599 received statin treatment. Statins use was associated with a reduced 30-day mortality after multivariable adjustment (HR 0.86, 95% CI, 0.78-0.94) and propensity score matching (HR, 0.88; 95% CI, 0.78-0.99). On subgroup analysis, the beneficial effects of statins were not significant in patients receiving ventilator support or requiring ICU admission. Conclusions In this national cohort study, preadmission statin therapy before sepsis development was associated with a 12% reduction in mortality when compared with patients who never received a statin. There were no consistent beneficial effects of statins in all patient subgroups.

原文英語
頁(從 - 到)645-654
頁數10
期刊British Journal of Anaesthesia
119
發行號4
DOIs
出版狀態已發佈 - 十月 1 2017

    指紋

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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