Royal Brisbane & Women's Hospital, Brisbane, QLD, Australia.
Acad Emerg Med. 2011 Feb;18(2):127-34. doi: 10.1111/j.1553-2712.2010.00976.x.
The objective was to determine whether prior statin use is associated with lower mortality in emergency patients admitted with infection.
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.
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.
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.
本研究旨在确定在因感染而住院的急诊患者中，既往使用他汀类药物是否与较低的死亡率相关。
这是一项在一家拥有每年超过 73000 名患者的三级成人医院急诊科进行的前瞻性观察性研究。在就诊后 24 小时内，确定在急诊科就诊并随后因感染而被收治入院的患者存在原发性感染诊断。从患者病历和医院电子数据库中提取数据。根据就诊时报告的常规他汀类药物使用情况对患者进行分层。主要转归为 30 天内的院内死亡率。使用逻辑回归分析来研究他汀类药物使用与死亡率之间的关系。
在 60 周的时间内，共收集了 2642 例住院患者的数据。与未使用他汀类药物的患者相比，就诊时使用他汀类药物的患者死亡风险更高（比值比[OR] = 2.14，95%置信区间[CI] = 1.32 至 3.46）。然而，在调整年龄、疾病严重程度、合并症状态和倾向评分后，这一结果变得无统计学意义（OR = 0.96，95%CI = 0.55 至 1.69）。
这些数据不支持在因感染而住院的急诊患者中，当前预入院他汀类药物使用与较低的 30 天院内死亡率之间存在独立关联。这一结果与大多数先前发表的研究结果相反。
