PURPOSE: HMG-CoA Reductase inhibitors (statins) have anti-inflammatory, antioxidant, and immunomodulatory properties that are independent of their lipid lowering ability. Studies have suggested these pleiotropic properties may preserve renal function and improve outcomes in critically ill patients. We evaluated the impact of HMG-CoA reductase inhibitors on renal function and mortality in patients with shock.
METHODS: A retrospective chart review on all patietns admitted to a mixed surgical and medical intensive care unit between 2005 to 2006 with an ICD-9 code for shock (785.50), cardiogenic (785.51), circulatory(785.59), or gram-negative (785.52) was conducted. The use of statins at the time of admission defined the stduy group. The primary outcome was development of renal failure and the secondary outcome was hopsital mortality.
RESULTS: 178 patients were identified with a diagnosis of shock. 53 (30%)of the patients were on statins at the time of admission to the ICU. There was no difference in the development of renal failure among the the two cohorts. 28% of patients in both groups developed renal failure. Hospital mortality was 50% for the no statin group and 49% for the statin group.
CONCLUSION: The use of HMG-CoA Reductase inhibitors at the time of admission did not prevent renal failure or improve hospital mortality among patients in shock.
CLINICAL IMPLICATIONS: HMG-CoA Reductase inhibitors may not have a protective role in patients with shock.
DISCLOSURE: Leonardo Seoane, None.