The association between prior statin use and long-term outcomes after critical care admission

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• 作者：M. Beed^a ; ^{martin.beed@nottingham.ac.uk" class="auth_mail" title="E-mail the corresponding author} ; ^{martin.beed@doctors.org.uk" class="auth_mail" title="E-mail the corresponding author} ; P.G. Brindley^b ; R. Mahajan^a ; I. Juttner^c ; J. Campion-Smith^c ; V.G. Wilson^c
• 关键词：Hydroxymethylglutaryl-CoA reductase inhibitors ; Sepsis ; Critical care ; Postoperative complications
• 刊名：Journal of Critical Care
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：35
• 期：Complete
• 页码：63-68
• 全文大小：472 K

文摘

Statins may have immunomodulatory effects that benefit critically ill patients. Therefore, we retrospectively examined the association between survival and the prescription of statins prior to admission to an intensive care unit (ICU), or high dependency unit (HDU), as a result of major elective surgery or as an emergency with a presumed diagnosis of sepsis.

Methods

We retrospectively studied critical care patients (ICU or HDU) from a tertiary referral UK teaching hospital. Nottingham University Hospitals have more than 2200 beds, of which 39 are critical care beds. Over a 5-year period (2000-2005), 414 patients were identified with a presumed diagnosis of sepsis, and 672 patients were identified who had planned ICU/HDU admissions following elective major surgery. Patients prescribed statins prior to hospital admission were compared with those who were not. Demographics, medical history, drug history, and Acute Physiology and Chronic Health Evaluation II scores were examined. Univariate and multivariate analyses were applied using the primary end point of survival at 5 years after admission.

Results

Patients prescribed statins prior to critical care admission were, on average, older and had higher initial Acute Physiology and Chronic Health Evaluation II scores and more preexisting comorbidities. Statins were almost invariably stopped following admission to critical care. Statin use was not associated with significantly altered survival during hospital admission, or at 5 years, for either patients with sepsis (9% vs 15%, P = .121; 73% vs 84%, P = .503, respectively) or postoperative patients (55% vs 58%, P = .762; 57% vs 63%, P = .390).

Conclusions

Prior statin use was not associated with improved outcomes in patients admitted to critical care after elective surgical cases or with a presumed diagnosis of sepsis.