Statin therapy in critical illness: an international survey of intensive care physicians' opinions, attitudes and practice Full Text
BMC Pharmacology & Toxicology, 07/12/2012
Hari MS et al. – Despite differences in type of statins prescribed, critical care physicians in the UK and ANZ reported similar prescription practices. Respondents from both communities agreed that a trial is needed to test whether statins can prevent the onset of new organ failure in patients with sepsis.Methods
- Survey questions were developed through an iterative process.
- An expert group reviewed the resulting 26 items for face and content validity and clarity.
- The questions were further refined following pilot testing by ICU physicians from Australia, Canada and the UK.
- Authors used the online Smart Survey software to administer the survey.
- Of 239 respondents (62 from ANZ and 177 from UK) 58% worked in teaching hospitals; most (78.2%) practised in 'closed' units with a mixed medical and surgical case mix (71.0%).
- The most frequently prescribed statins were simvastatin (77.6%) in the UK and atorvastatin (66.1%) in ANZ.
- The main reasons cited to explain the choice of statin were preadmission prescription and pharmacy availability.
- Most respondents reported never starting statins to prevent (65.3%) or treat (89.1%) organ dysfunction.
- Only a minority (10%) disagreed with a statement that the risks of major side effects of statins when prescribed in critically ill patients were low.
- The majority (84.5%) of respondents strongly agreed that a clinical trial of statins for prevention is needed.
- More than half (56.5%) favoured rates of organ failure as the primary outcome for such a trial, while a minority (40.6%) favoured mortality.