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长期与短期他汀类药物使用对菌血症患者死亡率的影响。

The impact of prior long-term versus short-term statin use on the mortality of bacteraemic patients.

机构信息

Department of Internal Medicine, Unit of Infectious Diseases, Holy Family Hospital, PO Box 8, 16100 Nazareth, Israel.

出版信息

Infection. 2012 Feb;40(1):41-8. doi: 10.1007/s15010-011-0190-9. Epub 2011 Sep 6.

Abstract

BACKGROUND

The aim of this investigation was to assess the effect of prior statin use on the 30-day in-hospital mortality among bacteraemic patients and to determine the impact of long-term versus short-term statin use on the mortality of bacteraemic patients.

PATIENTS AND METHODS

A retrospective study of 342 bacteraemic patients who presented to the emergency department (ED) within a period of 7 years was undertaken. Twenty-three patients did not meet the inclusion criteria. The remaining 319 patients were divided into three groups according to statin use and duration of therapy prior to the bacteraemic episode: group 1 (n = 123) had long-term statin use ≥ 12 weeks, group 2 (n = 35) had short-term statin use < 12 weeks, and group 3 (n = 161) had no statin use.

RESULTS

The overall 30-day in-hospital all-cause mortality of patients with statins was lower than patients without statin therapy (13 vs. 24%, p = 0.001). The mortality rate in group 1 was lower than in group 2 (11 vs. 17%, p = 0.04). After adjusting for confounding variables, the results of a multiple Cox regression analysis revealed that the absence of statin use (hazard ratio [HR] = 2.98; 95% confidence interval [CI] 1.59-5.56, p = 0.001) was associated with increased 30-day in-hospital all-cause mortality in bacteraemic patients.

CONCLUSIONS

Statins reduce the 30-day in-hospital all-cause mortality of bacteraemic patients. Long-term statin use prior to the bacteraemia improves the survival of bacteraemic patients more than short-term statin use.

摘要

背景

本研究旨在评估在菌血症患者中,他汀类药物的使用对 30 天住院病死率的影响,并确定长期和短期他汀类药物使用对菌血症患者病死率的影响。

方法

对在 7 年内因菌血症就诊于急诊科的 342 例患者进行回顾性研究。23 例患者不符合纳入标准。将其余 319 例患者根据他汀类药物的使用情况和菌血症发生前的治疗时间分为三组:组 1(n=123)长期使用他汀类药物≥12 周,组 2(n=35)短期使用他汀类药物<12 周,组 3(n=161)未使用他汀类药物。

结果

使用他汀类药物的患者 30 天全因院内病死率低于未使用他汀类药物的患者(13% vs. 24%,p=0.001)。组 1的病死率低于组 2(11% vs. 17%,p=0.04)。调整混杂变量后,多因素 Cox 回归分析的结果显示,未使用他汀类药物(风险比[HR]=2.98;95%置信区间[CI]1.59-5.56,p=0.001)与菌血症患者 30 天院内全因病死率增加相关。

结论

他汀类药物可降低菌血症患者 30 天住院病死率。菌血症发生前长期使用他汀类药物比短期使用更能提高菌血症患者的生存率。

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