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Anders Hammerich Riis

Preadmission use of statins and outcomes after hospitalization with pneumonia: population-based cohort study of 29,900 patients

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Preadmission use of statins and outcomes after hospitalization with pneumonia: population-based cohort study of 29,900 patients. / Thomsen, Reimar W; Riis, Anders; Kornum, Jette B; Christensen, Steffen; Johnsen, Søren P; Sørensen, Henrik T.

In: Archives of Internal Medicine, Vol. 168, No. 19, 2008, p. 2081-7.

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@article{aeb05190e61711dd8fc3000ea68e967b,
title = "Preadmission use of statins and outcomes after hospitalization with pneumonia: population-based cohort study of 29,900 patients",
abstract = "BACKGROUND: While some experimental and clinical research suggests that statins improve outcomes after severe infections, the evidence for pneumonia is conflicting. We examined whether preadmission statin use decreased risk of death, bacteremia, and pulmonary complications after pneumonia. METHODS: We conducted a population-based cohort study of 29,900 adults hospitalized with pneumonia for the first time between January 1, 1997, and December 31, 2004 in northern Denmark. Data on statin and other medication use, comorbidities, socioeconomic markers, laboratory findings, bacteremia, pulmonary complications, and death were obtained from medical databases. We used regression analyses to compute adjusted mortality rate ratios within 90 days and relative risks of bacteremia and pulmonary complications after hospitalization in both statin users and nonusers. RESULTS: Of patients with pneumonia, 1371 (4.6%) were current statin users. Mortality among statin users was lower than among nonusers: 10.3% vs 15.7% after 30 days and 16.8% vs 22.4% after 90 days, corresponding to adjusted 30- and 90-day mortality rate ratios of 0.69 (95% confidence interval, 0.58-0.82) and 0.75 (0.65-0.86). Decreased mortality associated with statin use remained robust in various subanalyses and in a supplementary analysis using propensity score matching. In contrast, former use of statins and current use of other prophylactic cardiovascular drugs were not associated with decreased mortality from pneumonia. In statin users, adjusted relative risk for bacteremia was 1.07 (95% confidence interval, 0.69-1.67) and for pulmonary complications was 0.69 (0.42-1.14). CONCLUSION: The use of statins is associated with decreased mortality after hospitalization with pneumonia.",
keywords = "Adolescent, Adult, Aged, Aged, 80 and over, Bacteremia, Cardiovascular Diseases, Cohort Studies, Denmark, Female, Hospitalization, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Logistic Models, Male, Middle Aged, Odds Ratio, Pneumonia",
author = "Thomsen, {Reimar W} and Anders Riis and Kornum, {Jette B} and Steffen Christensen and Johnsen, {S{\o}ren P} and S{\o}rensen, {Henrik T}",
year = "2008",
doi = "10.1001/archinte.168.19.2081",
language = "English",
volume = "168",
pages = "2081--7",
journal = "Archives of Internal Medicine",
issn = "0003-9926",
publisher = "The JAMA Network",
number = "19",

}

RIS

TY - JOUR

T1 - Preadmission use of statins and outcomes after hospitalization with pneumonia: population-based cohort study of 29,900 patients

AU - Thomsen, Reimar W

AU - Riis, Anders

AU - Kornum, Jette B

AU - Christensen, Steffen

AU - Johnsen, Søren P

AU - Sørensen, Henrik T

PY - 2008

Y1 - 2008

N2 - BACKGROUND: While some experimental and clinical research suggests that statins improve outcomes after severe infections, the evidence for pneumonia is conflicting. We examined whether preadmission statin use decreased risk of death, bacteremia, and pulmonary complications after pneumonia. METHODS: We conducted a population-based cohort study of 29,900 adults hospitalized with pneumonia for the first time between January 1, 1997, and December 31, 2004 in northern Denmark. Data on statin and other medication use, comorbidities, socioeconomic markers, laboratory findings, bacteremia, pulmonary complications, and death were obtained from medical databases. We used regression analyses to compute adjusted mortality rate ratios within 90 days and relative risks of bacteremia and pulmonary complications after hospitalization in both statin users and nonusers. RESULTS: Of patients with pneumonia, 1371 (4.6%) were current statin users. Mortality among statin users was lower than among nonusers: 10.3% vs 15.7% after 30 days and 16.8% vs 22.4% after 90 days, corresponding to adjusted 30- and 90-day mortality rate ratios of 0.69 (95% confidence interval, 0.58-0.82) and 0.75 (0.65-0.86). Decreased mortality associated with statin use remained robust in various subanalyses and in a supplementary analysis using propensity score matching. In contrast, former use of statins and current use of other prophylactic cardiovascular drugs were not associated with decreased mortality from pneumonia. In statin users, adjusted relative risk for bacteremia was 1.07 (95% confidence interval, 0.69-1.67) and for pulmonary complications was 0.69 (0.42-1.14). CONCLUSION: The use of statins is associated with decreased mortality after hospitalization with pneumonia.

AB - BACKGROUND: While some experimental and clinical research suggests that statins improve outcomes after severe infections, the evidence for pneumonia is conflicting. We examined whether preadmission statin use decreased risk of death, bacteremia, and pulmonary complications after pneumonia. METHODS: We conducted a population-based cohort study of 29,900 adults hospitalized with pneumonia for the first time between January 1, 1997, and December 31, 2004 in northern Denmark. Data on statin and other medication use, comorbidities, socioeconomic markers, laboratory findings, bacteremia, pulmonary complications, and death were obtained from medical databases. We used regression analyses to compute adjusted mortality rate ratios within 90 days and relative risks of bacteremia and pulmonary complications after hospitalization in both statin users and nonusers. RESULTS: Of patients with pneumonia, 1371 (4.6%) were current statin users. Mortality among statin users was lower than among nonusers: 10.3% vs 15.7% after 30 days and 16.8% vs 22.4% after 90 days, corresponding to adjusted 30- and 90-day mortality rate ratios of 0.69 (95% confidence interval, 0.58-0.82) and 0.75 (0.65-0.86). Decreased mortality associated with statin use remained robust in various subanalyses and in a supplementary analysis using propensity score matching. In contrast, former use of statins and current use of other prophylactic cardiovascular drugs were not associated with decreased mortality from pneumonia. In statin users, adjusted relative risk for bacteremia was 1.07 (95% confidence interval, 0.69-1.67) and for pulmonary complications was 0.69 (0.42-1.14). CONCLUSION: The use of statins is associated with decreased mortality after hospitalization with pneumonia.

KW - Adolescent

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Bacteremia

KW - Cardiovascular Diseases

KW - Cohort Studies

KW - Denmark

KW - Female

KW - Hospitalization

KW - Humans

KW - Hydroxymethylglutaryl-CoA Reductase Inhibitors

KW - Logistic Models

KW - Male

KW - Middle Aged

KW - Odds Ratio

KW - Pneumonia

U2 - 10.1001/archinte.168.19.2081

DO - 10.1001/archinte.168.19.2081

M3 - Journal article

C2 - 18955636

VL - 168

SP - 2081

EP - 2087

JO - Archives of Internal Medicine

JF - Archives of Internal Medicine

SN - 0003-9926

IS - 19

ER -