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. 2022 Feb 17;12(2):299.
doi: 10.3390/jpm12020299.

Statins Associated with Better Long-Term Outcomes in Aged Hospitalized Patients with COPD: A Real-World Experience from Pay-for-Performance Program

Ying-Yi Chen  1 , Tsai-Chung Li  1   2 , Chia-Ing Li  3 , Shih-Pin Lin  4   5 , Pin-Kuei Fu  5   6   7
Affiliations

Statins Associated with Better Long-Term Outcomes in Aged Hospitalized Patients with COPD: A Real-World Experience from Pay-for-Performance Program

Ying-Yi Chen et al. J Pers Med. .

Abstract

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death globally. Previous studies have addressed the impact of comorbidity on short-term mortality in patients with COPD. However, the prevalence of cardiovascular disease (CVD) and the association of statins prescription with mortality for aged COPD patients remains unclear. We enrolled 296 aged, hospitalized patients who were monitored in the pay-for-performance (P-4-P) program of COPD. Factors associated with long-term mortality were identified by Cox regression analysis. The median age of the study cohort was 80 years old, and the prevalence of coronary artery disease (CAD) and statins prescriptions were 16.6% and 31.4%, respectively. The mortality rate of the median 3-year follow-up was 51.4%. Through multivariate analysis, body mass index (BMI), statin prescription, and events of respiratory failure were associated with long-term mortality. A Cox analysis showed that statins prescription was associated with lower mortality (hazard ratio (HR): 0.5, 95% Confident interval, 95% CI: 0.34-0.73, p = 0.0004) and subgroup analysis showed that rosuvastatin prescription had protective effect on long-term mortality (HR: 0.44; 95% CI: 0.20-0.97; p < 0.05). Statin prescriptions might be associated with better long-term survival in aged COPD patients, especially those who experienced an acute exacerbation of COPD (AECOPD) who require hospitalization.

Keywords: COPD; aged; coronary artery disease; long-term outcomes; mortality; pay-for-performance; statins.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Enrollment and follow-up of the study participants. AECOPD: Acute exacerbation of COPD; COPD: chronic obstructive pulmonary disease; HbA1c: hemoglobin A1c. TCVGH: Taichung Veterans General Hospital; P-4-P: Pay-for-performance.
Figure 2
Figure 2
Cox regression model for survival analysis. Multivariate analysis adjusted with BMI, using statin and respiratory failure. ** p < 0.01. ICU: intensive care unit.
Figure 3
Figure 3
Kaplan-Meier survival curve of overall mortality in aged COPD patients according to use of statins.
See this image and copyright information in PMC

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