Key result
Preadmission statin use in critically ill patients was associated with lower 90-day mortality compared to non-use (8.5% vs 11.8%; HR 0.70; 95% CI 0.63-0.79; P<0.001).
Why the study?
To examine the association between preadmission statin use and 90-day mortality in critically ill patients, and whether it differed by statin type and dose.
Does preadmission statin use reduce 90-day mortality in critically ill adult patients?
Cohort (n=24,928)
No
Does preadmission statin use reduce 90-day mortality in critically ill adult patients?
Hazard Ratio: 0.7 (95% CI 0.63–0.79)
Absolute Event Rate: 8.5% vs 11.8%
p-value: p=<0.001
Preadmission statin use is associated with a significantly lower 90-day mortality in critically ill patients, primarily driven by a reduction in noncardiovascular mortality.
Preadmission statin use was associated with lower mortality; hypothesis-generating and should not change practice without randomized confirmation.
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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Oh et al. (2019) conducted a cohort in Critically ill (n=24,928). Preadmission statin use vs. Non-statin users was evaluated on 90-day mortality (HR 0.70, 95% CI 0.63-0.79, p=<0.001). Preadmission statin use in critically ill patients was associated with lower 90-day mortality compared to non-use (8.5% vs 11.8%; HR 0.70; 95% CI 0.63-0.79; P<0.001).
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