[Effects of statins on mortality in patients with infection: a systematic review]

To review systematically the literatures regarding the effect of statins on mortality in patients with infection.

PUBMED, EMBASE, Web of Science and CNKI databases from 2000 to 2010 were searched. And the clinical trials on statins-related mortality in patients with infection were identified by electronic and manual searching. A systematic review of relevant data was conducted by the methods as recommended by the Cochrane Collaboration.

Sixteen trials (11 retrospective and 5 prospective cohort studies) involving 8775 cases in statins group and 46 539 in control group were included for analysis. The mortalities of infection were 5.2% (458/8775) and 18.6% (8637/46 539) in statins and control groups respectively. In comparison with control group, statins could reduce the mortality in patients with infection [OR = 0.51, (95% CI: 0.36 - 0.71); P < 0.000 01]. Prospective cohort studies observed 6774 patients with infection whose survival were improved by statins [OR = 0.48, (95% CI: 0.24 - 0.94); P = 0.03]. It was consistent with the results of retrospective cohort studies [OR = 0.66, (95% CI: 0.58 - 0.75); P = 0.002] and large sample studies [OR = 0.56, (95% CI: 0.50 - 0.63); P = 0.02]. Statins lowered the short-term mortality [OR = 0.47, (95% CI: 0.29 - 0.78); P = 0.004], but failed to improve the outcomes of severe septic patients in Intensive Care Unit (ICU) [OR = 0.69, (95% CI: 0.32 - 1.48); P = 0.34].

Statins have favorable effects on the patients with infection, but there is no effect for severe septic patients in ICU. Further randomized controlled trials of a large sample size are warranted.