The association between prior statin use and long-term outcomes after critical care admission

Beed, M.; Brindley, P.G.; Mahajan, R.; Juttner, I.; Campion-Smith, J.; Wilson, V.G.

Abstract

Background:
Statins may have immunomodulatory effects that benefit critically ill patients. Therefore we retrospectively examined the association between survival and the prescription of statins prior to admission to an intensive care unit (ICU), or high dependency unit (HDU), as a result of major elective surgery, or as an emergency with a presumed diagnosis of sepsis.

Methods:
We retrospectively studied critical care patients (ICU or HDU) from a tertiary referral UK teaching hospital. Nottingham University Hospitals has over 2200 beds, of which 39 are critical care beds. Over a five-year period (2000–2005) 414 patients were identified with a presumed diagnosis of sepsis, and 672 patients were identified with a planned ICU/HDU admission following elective major surgery. Patients prescribed statins prior to hospital admission were compared with those who were not. Demographics, past medical history, drug history, and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores were examined. Univariate and multivariate analyses were applied using the primary endpoint of survival at five years after admission.

Results:
Patients prescribed statins prior to critical care admission were, on average, older, with higher initial APACHE II scores and more pre-existing comorbidities. Statins were almost invariably stopped following admission to critical care. Statin usage was not associated with significantly altered survival during hospital admission, or at five years, for either patients with sepsis (9% v 15%, P=0.121; 73% v 84%, P=0.503 respectively), or post-operative patients (55% v 58%, P=0.762; 57% v 63%, P=0.390).

Conclusions:
Prior statin usage was not associated with improved or worsening outcomes in patients admitted to critical care after elective surgical cases or with a presumed diagnosis of sepsis.

Citation

Beed, M., Brindley, P., Mahajan, R., Juttner, I., Campion-Smith, J., & Wilson, V. (2016). The association between prior statin use and long-term outcomes after critical care admission. Journal of Critical Care, 35, 63-68. https://doi.org/10.1016/j.jcrc.2016.04.031

• Journal Article Type: Article
• Acceptance Date: Apr 29, 2016
• Online Publication Date: May 4, 2016
• Publication Date: 2016-10
• Deposit Date: Jul 28, 2016
• Publicly Available Date: Jul 28, 2016
• Journal: Journal of Critical Care
• Print ISSN: 0883-9441
• Electronic ISSN: 1557-8615
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 35
• Pages: 63-68
• DOI: https://doi.org/10.1016/j.jcrc.2016.04.031
• Keywords: Hydroxymethylglutaryl-CoA Reductase Inhibitors; Sepsis; Critical Care; Postoperative Complications
• Public URL: https://nottingham-repository.worktribe.com/output/791429
• Publisher URL: http://www.sciencedirect.com/science/article/pii/S0883944116300570
• Additional Information: This article is maintained by: Elsevier; Article Title: The association between prior statin use and long-term outcomes after critical care admission; Journal Title: Journal of Critical Care; CrossRef DOI link to publisher maintained version: https://doi.org/10.1016/j.jcrc.2016.04.031; Content Type: article; Copyright: © 2016 Elsevier Inc. All rights reserved.