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The impact of statin use on pneumonia risk and outcome: a combined population-based case-control and cohort study
Critical Care, 07/13/2012
Clinical Article
Nielsen AG et al. – Current statin use was associated with both a decreased risk of hospitalization for pneumonia and lower 30–day mortality following pneumonia.
Methods- The authors identified 70,953 adults with a first–time hospitalization for pneumonia between 1997 and 2009 in Northern Denmark.
- Ten age– and sex–matched population controls were selected for each pneumonia patient.
- To control for potential confounders, they retrieved individual–level data on other medications, comorbidities, recent surgery, socioeconomic indicators, influenza vaccination, and other markers of frailty or health awareness from medical databases.
- They followed all pneumonia patients for 30days after hospital admission.
- A total of 7,223 pneumonia cases (10.2%) and 64 523 controls (9.1%) were statin users before admission, corresponding to an age– and sex–matched odds ratio (OR) of 1.17 (95% confidence interval [CI]: 1.14–1.21).
- After controlling for higher comorbidity and a wide range of other potential confounders, the adjusted OR for pneumonia associated with current statin use dropped to 0.80 (95% CI: 0.77–0.83).
- Previous statin use was not associated with decreased pneumonia risk (adjusted OR=0.97, 95% CI: 0.91–1.02).
- Decreased risk remained significant after further adjustment for frailty and health awareness markers.
- The prevalence of statin use among Danish pneumonia patients increased from 1% in 1997 to 24% in 2009.
- Thirty–day mortality following pneumonia hospitalization was 11.3% among statin users versus 15.1% among nonusers.
- This corresponded to a 27% reduced mortality rate (adjusted hazard ratio=0.73, 95% CI: 0.67–0.79), corroborating the earlier findings.
