Résumé
Objectives: The objective was to determine whether prior statin use is associated with lower mortality in emergency patients admitted with infection.
Methods: A prospective observational study was conducted at the emergency department (ED) of a tertiary adult hospital with an annual census of over 73,000 patients. Patients presenting to the ED who were subsequently hospitalized with a primary diagnosis of infection were identified within 24 hours of presentation. Data were abstracted from patients' charts and from hospital electronic databases. Patients were stratified according to reported regular statin use on presentation. The outcome measure was in-hospital mortality truncated at 30 days. An association between statin use and mortality was sought using logistic regression analysis.
Results: Data were collected over a 60-week period from 2,642 admissions. Patients taking a statin on admission had a higher unadjusted mortality risk (odds ratio [OR] = 2.14, 95% confidence interval [CI] = 1.32 to 3.46) compared to those not on a statin. However, this result became nonsignificant (OR = 0.96, 95% CI = 0.55 to 1.69) after adjusting for age, severity of disease, comorbid status, and propensity score.
Conclusions: These data do not support an independent association between current preadmission statin use and lower 30-day in-hospital mortality in emergency patients admitted with infection. This result is contrary to most previously published studies. ACADEMIC EMERGENCY MEDICINE 2011; 18:127-134 (C) 2011 by the Society for Academic Emergency Medicine