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Intensive Care Med ; 40(10): 1509-17, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-25091791

RESUMEN

INTRODUCTION: Although statins have been shown to have cholesterol-lowering effects, their pleiotropic benefits on sepsis remain a matter of debate. In addition, the influence of statin potency on sepsis-related mortality has never been explored. The aim of our study was to determine the sepsis outcomes of low- and high-potency statin users and non-users. METHODS: This nationwide, population-based, propensity score-matched analysis used data from the linked administrative databases of Taiwan's National Health Insurance program. Patients were hospitalized for sepsis between 2000 and 2010. All-cause mortality and major adverse consequences of sepsis, such as in-hospital death, intensive care unit admission, shock events, and the use of mechanical ventilation, were assessed. Patients were divided into high-potency statin users (at least 10 mg rosuvastatin, at least 20 mg atorvastatin, or at least 40 mg simvastatin), low-potency statin users (all other statin treatments), and non-users. RESULTS: A propensity score-matched cohort of 27,792 statin users and 27,792 non-users was included. Of 27,792 statin users, 9,785 (35.2 %) were treated with high-potency statins and 18,007 (64.8 %) were treated with low-potency statins. The 1-year mortality risk was significantly lower among both low-potency [adjusted hazard ratio (aHR) 0.89, 95 % confidence interval (CI) 0.85-0.93] and high-potency (aHR 0.80, 95 % CI 0.75-0.86) statin users compared with non-users. The risks of mortality and adverse consequences of sepsis were lower among high-potency than among low-potency statin users. CONCLUSIONS: High-potency statin use is associated with a lower risk of sepsis-related mortality compared with low-potency statin use.


Asunto(s)
Inhibidores de Hidroximetilglutaril-CoA Reductasas/administración & dosificación , Sepsis/tratamiento farmacológico , Sepsis/mortalidad , Anciano , Comorbilidad , Femenino , Mortalidad Hospitalaria , Humanos , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Revisión de Utilización de Seguros/estadística & datos numéricos , Estimación de Kaplan-Meier , Masculino , Programas Nacionales de Salud/estadística & datos numéricos , Evaluación de Procesos y Resultados en Atención de Salud/estadística & datos numéricos , Puntaje de Propensión , Modelos de Riesgos Proporcionales , Medición de Riesgo , Sepsis/complicaciones , Taiwán/epidemiología
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