The impact of statin use prior to intensive care unit admission on critically ill patients with sepsis

Chinaeke, Eric E.; Love, Bryan L.; Magagnoli, Joe; Yunusa, Ismaeel; Reeder, Gene

doi:10.1002/phar.2506

Cited by 16 publications

(13 citation statements)

References 28 publications

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“…The association of pre-ICU statin use with mortality showed no sex differences but differed with AKI stages. Finally, sensitivity analyses con rmed the robustness of our results.Chinaeke et al showed that patients in ICU with sepsis who had pre-ICU statin use had decreased mortality and ICU LOS, demonstrating the pleiotropic effect of statin[21]. Our study was based on ICU patients with AKI, similar but different population with Chinaeke's, also showed an association between pre-ICU statin use and outcomes.…”

supporting

confidence: 55%

“…We de ned pre-ICU statin users as patients with records of statins, including the brand and generic names of medicines, otherwise as non-users. The type of statin was referred to other authors' study based on MIMIC-III database [21], it is also applicable to MIMIC-IV database through careful veri cation. The prescriptions of the medicines were recorded in the MIMIC-IV v1.0 "PRESCRIPTION" le.…”

Section: Medication Exposurementioning

confidence: 99%

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Impact of Prior to Intensive Care Unit Statin use on Patients with Acute Kidney Injury

Tang

Cheng

et al. 2021

Preprint

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Purpose: To evaluate if prior to intensive care unit (ICU) statin use improve the clinical outcomes, for critically ill patients with acute kidney injury (AKI).Materials and Methods: Patients with AKI were selected from the Medical Information Mart for Intensive Care IV v1.0 database for this retrospective observational study. The primary outcome was 30-day ICU mortality. 30-day in-hospital mortality and ICU length of stay (LOS) were considered as secondary outcomes. Comparison of mortality between pre-ICU statin users with non-users was conducted by multivariable cox proportional hazards model. Comparison of ICU LOS between two groups was implemented by multivariable linear model. Three propensity score methods were used to verify the results as sensitivity analyses. Stratification analyses were conducted to explore whether the association between pre-ICU statin use and mortality differed across various subgroups classified by sex and different AKI stages.Results: 3821 pre-ICU statin users and 9690 non-users were identified. In multivariable model, pre-ICU statin use was associated with reduced 30-day ICU mortality rate [Hazara ratio (HR) 0.68 (0.59,0.79); P<0.001], 30-day in-hospital mortality rate [HR 0.64 (0.57, 0.72); P<0.001] and ICU LOS [Mean Difference -0.51(-0.79, -0.24); P<0.001]. The conclusions were consistent in three propensity score methods. In Subgroup analyses, pre-ICU statin use was associated with decreased 30-day ICU mortality and 30-day in-hospital mortality in both sexes and AKI stages, only except for 30-day ICU mortality in AKI stage 1.Conclusions: Patients with AKI who were administered statins prior to ICU admission might have lower mortality rate during ICU or hospital stay and shorter ICU LOS.

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supporting

confidence: 55%

Section: Medication Exposurementioning

confidence: 99%

Impact of Prior to Intensive Care Unit Statin use on Patients with Acute Kidney Injury

Tang

Cheng

et al. 2021

Preprint

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“…Finally, sensitivity analyses confirmed the robustness of our results. Chinaeke et al showed that patients in ICU with sepsis who had pre-ICU statin use had decreased mortality and ICU LOS, demonstrating the pleiotropic effect of statin (20). This study was based on ICU patients with AKI, similar but different population from theirs, and showed an association between pre-ICU statin use and outcomes.…”

Section: Discussionmentioning

confidence: 68%

“…The schematic that illustrates statin exposure and follow-up was shown in Supplementary Figure S1. The types of statin used were referred to other study based on the MIMIC-III database (20) and they are also applicable to the MIMIC-IV database through our careful verification. The prescriptions of the medicines were recorded in the MIMIC-IV (version 1.0) "Prescription" table.…”

Section: Medication Exposurementioning

confidence: 99%

Association of Prior to Intensive Care Unit Statin Use With Outcomes on Patients With Acute Kidney Injury

Tang

Cheng

et al. 2021

Front. Med.

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Purpose: To evaluate the association of prior to intensive care unit (ICU) statin use with the clinical outcomes in critically ill patients with acute kidney injury (AKI).Materials and Methods: Patients with AKI were selected from the Medical Information Mart for Intensive Care IV (version 1.0) database for this retrospective observational study. The primary outcome was 30-day intensive care unit (ICU) mortality. A 30-day in-hospital mortality and ICU length of stay (LOS) were considered as secondary outcomes. Comparison of mortality between pre-ICU statin users with non-users was conducted by the multivariate Cox proportional hazards model. Comparison of ICU LOS between two groups was implemented by multivariate linear model. Three propensity score methods were used to verify the results as sensitivity analyses. Stratification analyses were conducted to explore whether the association between pre-ICU statin use and mortality differed across various subgroups classified by sex and different AKI stages.Results: We identified 3,821 pre-ICU statin users and 9,690 non-users. In multivariate model, pre-ICU statin use was associated with reduced 30-day ICU mortality rate [hazard ratio (HR) 0.68 (0.59, 0.79); p < 0.001], 30-day in-hospital mortality rate [HR 0.64 (0.57, 0.72); p < 0.001] and ICU LOS [mean difference −0.51(−0.79, −0.24); p < 0.001]. The results were consistent in three propensity score methods. In subgroup analyses, pre-ICU statin use was associated with decreased 30-day ICU mortality and 30-day in-hospital mortality in both sexes and AKI stages, except for 30-day ICU mortality in AKI stage 1.Conclusion: Patients with AKI who were administered statins prior to ICU admission might have lower mortality during ICU and hospital stay and shorter ICU LOS.

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“…If there is no convincing evidence that statins as a treatment initiated for sepsis improves survival, the effect of chronic statin use on the incidence and outcome of sepsis is less clear, as most randomized control trials excluded patients previously on statins [ 31 , 32 ]. Several studies have suggested that chronic statin use may be associated with decreased rate of severe sepsis, ICU admission [ 35 ] and mortality [ 36 , 37 ]. A large Canadian population-based cohort analysis including approximately 141,000 patients reported that the use of statins in patients with atherosclerosis was associated with a reduced risk of subsequent sepsis (HR 0.81, 95% CI 0.72–0.90), severe sepsis (HR 0.83, 95% CI 0.70–0.97) and fatal sepsis (0.75, 95% CI 0.61–0.93) after adjustment for demographic characteristics, comorbidities and sepsis risk factors [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Effects of Statins on the Incidence and Mortality of Sepsis in Patients with New Cancer Diagnosis

Louw

Cohrs

Leslie

2021

JCM

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Statins have been associated with improved survival in cancer patients and with decreased incidence and mortality of sepsis in different populations. Our objective was to assess whether newly diagnosed cancer patients on statins had decreased incidence and mortality of sepsis. We analyzed a US database and included 119,379 patients with a new cancer diagnosis (age 55 (50–60) years, 61% female), 19,468 of them (16%) receiving statins. Statins users were older and presented more comorbidities. After adjustment for baseline characteristics, statin use was associated with decreased death hazard (HR 0.897, 95% CI 0.851–0.945, p < 0.0001). The cumulative incidence of sepsis reached 10% at 5 years but statin use was not significantly associated with sepsis hazard (subdistribution hazard ratio 0.990, 95% CI 0.932–1.050, p = 0.73), including in sensitivity analyzes in patients with hematological malignancy or sepsis within 1 year. In patients subsequently hospitalized with sepsis, hospital mortality was 23% and statin use was not associated with mortality (odds ratio 0.952, 95% CI 0.829–1.091, p = 0.48), including in sensitivity analyzes in patients with septic shock and use of statins at the time of sepsis. In summary, treatment with statin at the time of new cancer diagnosis is not associated with a decreased incidence and mortality of sepsis.

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The impact of statin use prior to intensive care unit admission on critically ill patients with sepsis

Cited by 16 publications

References 28 publications

Impact of Prior to Intensive Care Unit Statin use on Patients with Acute Kidney Injury

Impact of Prior to Intensive Care Unit Statin use on Patients with Acute Kidney Injury

Association of Prior to Intensive Care Unit Statin Use With Outcomes on Patients With Acute Kidney Injury

Effects of Statins on the Incidence and Mortality of Sepsis in Patients with New Cancer Diagnosis

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