Association of statin therapy with 30- and 180-day mortality in patients with bacteraemia: population-based cohort study
Abstract number: 1133_156
Thomsen R.W., Hundborg H.H., Johnsen S.P., Sørensen H.T., Schønheyder H.C., Lervang H.-H.
Statins may decrease the risk of severe sepsis and death among patients hospitalized with bacterial infections, due to anti-inflammatory effects. We conducted this population-based cohort study to examine the effect of statin therapy on short- and long-term mortality in patients with bacteraemia.
We retrieved all patients hospitalized with bacteraemia in North Jutland County, Denmark, from January 1997 to December 2002 from the County Bacteremia Registry. Using civil registry numbers, patients treated with statins were identified by record-linkage with the County Prescription Database. Mortality within 180 days after the bacteraemia was determined through the Central Population Registry. Mortality rates were compared for patients with and without statin therapy, adjusted for gender, age, comorbidity, use of antibiotic or immunosuppressive drugs, and focus of infection.
Among 5353 patients older than 15 years hospitalized with bacteraemia, 176 received statin therapy before admission. The 30-day mortality in statin users vs. non-users was similar (20.0% vs. 21.6%, adjusted mortality rate ratio (MRR) 0.9, 95% CI 0.71.3). Among survivors 30 days after the bacteraemia, however, statin therapy was associated with a substantial decrease in mortality during the subsequent period up till 180 days after the infection (8.4% vs. 17.5%, adjusted MRR 0.4, 95% CI 0.20.8). The tendency towards similar short-term mortality and decreased long-term mortality rates in statin users was observed in both community-acquired and nosocomial bacteraemia episodes, and for various microbiologic agents and foci of infection. When analyses were restricted to patients with a prior medical indication for statin use (ischemic heart disease, stroke, peripheral atherosclerosis, or diabetes), the adjusted 30-day MRR among statin users was 1.1 (95% CI 0.81.6), and the adjusted MRR from 30 to 180 days was 0.5 (95% CI 0.31.0).
By contrast with previous smaller reports, in this population-based study statin use was not associated with a better prognosis within 30 days after an episode of bacteraemia, where most directly infection-related deaths may take place. Statins, however, seem to be associated with a substantially decreased long-term mortality after bacteraemia.
|Session name:||XXIst ISTH Congress|
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