Preadmission Statin Use and 90-day Mortality in the Critically Ill A Retrospective Association Study
- Authors
- Oh, Tak Kyu; Song, In-Ae; Lee, Jae Ho; Lim, Cheong; Jeon, Young-Tae; Bae, Hee-Joon; Jo, You Hwan; Jee, Hee-Jung
- Issue Date
- Aug-2019
- Publisher
- Lippincott Williams & Wilkins Ltd.
- Citation
- Anesthesiology, v.131, no.2, pp 315 - 327
- Pages
- 13
- Indexed
- SCI
SCIE
SCOPUS
- Journal Title
- Anesthesiology
- Volume
- 131
- Number
- 2
- Start Page
- 315
- End Page
- 327
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/34028
- DOI
- 10.1097/ALN.0000000000002811
- ISSN
- 0003-3022
1528-1175
- Abstract
- Editor’s Perspective
What We Already Know about This Topic
o Randomized controlled trials evaluating the potential value of statin administration for intensive care unit patients have not observed a benefit
o However, the chronic preadmission use of statins among patients admitted to the intensive care unit has not been robustly studied
What This Article Tells Us That Is New
o Single-center retrospective data suggest that preadmission statin use may be associated with decreased 90-day mortality among some intensive care unit patients
o Specific statin agents and noncardiovascular mortality may demonstrate a stronger signal for further study
Background
This study aimed to examine the association between preadmission statin use and 90-day mortality in critically ill patients and to investigate whether this association differed according to statin type and dose. We hypothesized that preadmission statin use was associated with lower 90-day mortality.
Methods
This retrospective cohort study analyzed the medical records of all adult patients admitted to the intensive care unit in a single tertiary academic hospital between January 2012 and December 2017. Data including preadmission statin use, statin subtype, and daily dosage were collected, and the associations between these variables and 90-day mortality after intensive care unit admission were examined. The primary endpoint was 90-day mortality.
Results
A total of 24,928 patients (7,396 statin users and 17,532 non–statin users) were included. After propensity score matching, 5,354 statin users and 7,758 non–statin users were finally included. The 90-day mortality rate was significantly higher in non–statin users (918 of 7,758; 11.8%) than in statin users (455 of 5,354; 8.5%; P < 0.001). In Cox regression analysis, the 90-day mortality rate was lower among statin users than among non–statin users (hazard ratio: 0.70, 95% CI: 0.63 to 0.79; P < 0.001). Rosuvastatin use was associated with 42% lower 90-day mortality (hazard ratio: 0.58, 95% CI: 0.47 to 0.72; P < 0.001). There were no specific significant differences in the association between daily statin dose and 90-day mortality. In competing risk analysis, the risk of noncardiovascular 90-day mortality in statin users was 32% lower than that in non–statin users (hazard ratio: 0.68, 95% CI: 0.60 to 0.78; P < 0.001). Meanwhile, cardiovascular 90-day mortality was not significantly associated with statin use.
Conclusions
Preadmission statin use was associated with a lower 90-day mortality. This association was more evident in the rosuvastatin group and with noncardiovascular 90-day mortality; no differences were seen according to daily dosage intensity.
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Collections - 1. Basic Science > Department of Biostatistics > 1. Journal Articles
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