Health Services Research & Development

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2006 HSR&D National Meeting Abstract


1020 — Impact of Prior Statin Use on Mortality for Patients Hospitalized with Community-Acquired Pneumonia

Author List:
Mortensen EM (VERDICT)
Pugh MJ (VERDICT)
Cornell J (VERDICT)
Copeland L (VERDICT)
Restrepo MI (VERDICT)
Pugh JA (VERDICT)

Objectives:
Recent studies suggest that HMG-CoA reductase inhibitors (“statins”) reduce systemic inflammation due to cytokines, and may be associated with improved survival for patients at risk for some types of infections. Our aim was to examine the effect of current outpatient statin use at admission on 30-day mortality for patients hospitalized with community-acquired pneumonia (CAP).

Methods:
A retrospective cohort study using Veterans Health Administration (VA) administrative data of patients > 65 years of age hospitalized with CAP in 18 of 21 networks in fiscal year 2000. Patients were included if they had previously validated ICD-9 criteria for CAP, and excluded if they did not have at least 1 year of VA primary care. The dependent variable was 30-day mortality, which has been demonstrated to be primarily CAP-related. The primary analysis was a generalized linear mixed-effect model with hospital as a random effect, and control variables including comorbid conditions, demographics, and other medications.

Results:
We identified 6605 patients hospitalized with CAP that met our inclusion/exclusion criteria. The mean age was 75 years, 98% were male, 25.4% of patients died within 30-days of presentation, and 7.2% of patients were taking statins at presentation. After adjusting for potential confounders, current statin use was significantly associated with decreased 30-day mortality (odds ratio 0.5, 95% confidence interval 0.4-0.7).

Implications:
Current outpatient statin use at presentation is associated with decreased mortality in patients hospitalized with CAP.

Impacts:
CAP-related mortality could be potentially reduced by the use of statins in patients hospitalized with CAP, pending further confirmatory studies.