Malbouisson Isabelle, Quinto Beata Marie, Durão Junior Marcelino de Souza, Monte Júlio Cesar Martins, Santos Oscar Fernando Pavão Dos, Narciso Roberto Camargo, Dalboni Maria Aparecida, Batista Marcelo Costa
Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Einstein (Sao Paulo). 2019 May 30;17(3):eAO4399. doi: 10.31744/einstein_journal/2019AO4399.
To determine whether pre-hospital statin use is associated with lower renal replacement therapy requirement and/or death during intensive care unit stay.
Prospective cohort analysis. We analyzed 670 patients consecutively admitted to the intensive care unit of an academic tertiary-care hospital. Patients with ages ranging from 18 to 80 years admitted to the intensive care unit within the last 48 hours were included in the study.
Mean age was 66±16.1 years old, mean body mass index 26.6±4/9kg/m2 and mean abdominal circumference was of 97±22cm. The statin group comprised 18.2% of patients and had lower renal replacement therapy requirement and/or mortality (OR: 0.41; 95%CI: 0.18-0.93; p=0.03). The statin group also had lower risk of developing sepsis during intensive care unit stay (OR: 0.42; 95%CI: 0.22-0.77; p=0.006) and had a reduction in hospital length-of-stay (14.7±17.5 days versus 22.3±48 days; p=0.006). Statin therapy was associated with a protective role in critical care setting independently of confounding variables, such as gender, age, C-reactive protein, need of mechanical ventilation, use of pressor agents and presence of diabetes and/or coronary disease.
Statin therapy prior to hospital admission was associated with lower mortality, lower renal replacement therapy requirement and sepsis rates.
确定院前使用他汀类药物是否与重症监护病房住院期间较低的肾脏替代治疗需求和/或死亡相关。
前瞻性队列分析。我们分析了一家学术性三级护理医院重症监护病房连续收治的670例患者。纳入研究的患者为过去48小时内入住重症监护病房、年龄在18至80岁之间的患者。
平均年龄为66±16.1岁，平均体重指数为26.6±4.9kg/m²，平均腹围为97±22cm。他汀类药物组占患者的18.2%，其肾脏替代治疗需求和/或死亡率较低（比值比：0.41；95%置信区间：0.18 - 0.93；p = 0.03）。他汀类药物组在重症监护病房住院期间发生脓毒症的风险也较低（比值比：0.42；95%置信区间：0.22 - 0.77；p = 0.006），且住院时间缩短（14.7±17.5天对22.3±48天；p = 0.006）。他汀类药物治疗在重症监护环境中具有保护作用，独立于混杂变量，如性别、年龄、C反应蛋白、机械通气需求、使用升压药以及是否存在糖尿病和/或冠心病。
入院前使用他汀类药物治疗与较低的死亡率、较低的肾脏替代治疗需求和脓毒症发生率相关。
