Association between statin administration and outcome in patients with sepsis: A retrospective study

Background & aims - There was considerable debate regarding the effect of statins administration on the outcome of septic patients. This retrospective study aimed to assess the association between statins administration and mortality in sepsis patients and investigate whether this association differed according to the types of statins. Methods - We performed a retrospective study based on the electronic ICU Collaborative Research Database, Medical Information Mart for Intensive Care Database, and the Amsterdam University Medical Centers Database. The participants with sepsis were divided as two groups, statins group and non-statins group. The primary endpoint was the all-cause mortality. We utilized logistic regression, propensity score matching (PSM), and sub-analysis to assess the association between statins administration and outcome in patients with sepsis. Results - A total of 19,327 sepsis patients were enrolled. Among these, 3,721 patients were prescribed statins. Pooled analyses of three databases showed that statin users had a decreased risk of mortality in sepsis as compared with nonusers (OR 0.73, 95% CI 0.66-0.80, P < 0.001). Sub-analysis of statin showed that atorvastatin had the most distinct effectiveness in decreasing mortality (OR 0.67, 95% CI 0.59-0.76, P = 0.035), whereas pravastatin, simvastatin, and rosuvastatin were not. PSM analysis confirmed these findings for statins (OR 0.75, 95% CI 0.67-0.84, P < 0.001) and atorvastatin (OR 0.70, 95% CI 0.59-0.82, P < 0.001). Conclusions - The use of statins could decrease the risk of mortality in patients with sepsis during the hospital period. Among different types of statins, atorvastatin showed the most significant trend to reduce the risk of mortality in patients with sepsis.