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Multicenter Study
. 2006 Nov 11;333(7576):999.
doi: 10.1136/bmj.38992.565972.7C. Epub 2006 Oct 23.

Statins and outcomes in patients admitted to hospital with community acquired pneumonia: population based prospective cohort study

Sumit R Majumdar  1 , Finlay A McAlister, Dean T Eurich, Raj S Padwal, Thomas J Marrie
Affiliations
Multicenter Study

Statins and outcomes in patients admitted to hospital with community acquired pneumonia: population based prospective cohort study

Sumit R Majumdar et al. BMJ. .

Abstract

Objectives: To determine whether statins reduce mortality or need for admission to intensive care in patients admitted to hospital with community acquired pneumonia; and to assess whether previously reported improvements in sepsis related outcomes were a result of the healthy user effect.

Design: Population based prospective cohort study.

Setting: Six hospitals in Capital Health, Edmonton, Alberta, Canada.

Participants: Adults admitted to hospital with pneumonia and categorised according to use of statins for at least one week before admission and during hospital stay.

Main outcome measures: Composite of in-hospital mortality or admission to an intensive care unit.

Results: Of 3415 patients with pneumonia admitted to hospital, 624 (18%) died or were admitted to an intensive care unit. Statin users were less likely to die or be admitted to an intensive care unit than non-users (50/325 (15%) v 574/3090 (19%), odds ratio 0.80, P=0.15). After more complete adjustment for confounding, however, the odds ratios changed from potential benefit (0.78, adjusted for age and sex) to potential harm (1.10, fully adjusted including propensity scores, 95% confidence interval 0.76 to 1.60).

Conclusions: Statins are not associated with reduced mortality or need for admission to an intensive care unit in patients with pneumonia; reports of benefit in the setting of sepsis may be a result of confounding.

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Conflict of interest statement

Competing interests: None declared.

Figures

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Odds ratios (95% confidence intervals) for association between statin use and death or admission to an intensive care unit in patients with community acquired pneumonia in models with progressively more complete multivariate adjustment for confounding and comorbidities (ischaemic heart disease, heart failure, chronic obstructive pulmonary disease, and neuropsychiatric illness)
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References

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