PURPOSE: Studies have shown decreased mortality for specific illnesses (CAD, COPD, sepsis, pneumonia, etc.) in patients on statin therapy. The purpose of this study was to determine if there was an all-cause mortality benefit for patients already receiving statin therapy prior to ICU admission.
METHODS: This was a retrospective medical record review performed at a community teaching hospital. Included patients on statins were admitted to the ICU between 2004-2010. Patients admitted for acute myocardial infarction or who had undergone CABG surgery were excluded. Statin patients meeting inclusion criteria were matched to control patients by age, gender, primary diagnosis and Charlson Comorbidity Index (CCI). To maximize number of possible non-statin control matches for each patient, the database was searched from 2000-2010. The investigators were blinded to the outcome of the patients until after the matching was finished. One-way analysis of variance was performed to determine the significance of mortality differences between the groups.
RESULTS: 323 patients on statins originally met inclusion criteria but 93 of these could not be matched by one of the four matching criteria. 460 patients in total were included in the study. 230 subjects comprised the statin cohort made up of 130 males and 100 females. Mortality rate differences were statistically significant for the cohort as a whole (35% control vs. 24% statin; 95% confidence interval for mortality benefit [CI] = 5.3% to 16.7%, p< .01), for females alone (37% vs 21%; CI = 5.8% to 26.2%, p< .01) and for male patients alone (34% vs. 26%; CI = 1.4% to 14.6%, p= .08).
CONCLUSION: This study demonstrates a significant survival benefit for a cohort of patients admitted to the ICU who were already receiving statin therapy prior to admission. Subgroup analysis suggests that the greatest benefit is significant among female patients while males trended towards mortality benefit but did not reach statistical significance.
CLINICAL IMPLICATIONS: Prophylactic use of statins in patients who are high risk for possible ICU admission might benefit by a significant reduction in mortality.
DISCLOSURE: Eric Gluck, No Financial Disclosure Information; No Product/Research Disclosure Information