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Statins and outcomes in patients admitted to hospital with community acquired pneumonia: population based prospective
Sumit R Majumdar1, Finlay A McAlister, Dean T Eurich
1Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada. me2.majumdar@ualberta.ca
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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