Skip to main content
main-content

01.08.2011 | Research | Ausgabe 4/2011 Open Access

Critical Care 4/2011

Effects of discontinuing or continuing ongoing statin therapy in severe sepsis and septic shock: a retrospective cohort study

Zeitschrift:
Critical Care > Ausgabe 4/2011
Autoren:
Armand Mekontso Dessap, Islem Ouanes, Nerlep Rana, Beatrice Borghi, Christophe Bazin, Sandrine Katsahian, Anne Hulin, Christian Brun-Buisson
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​cc10317) contains supplementary material, which is available to authorized users.
Armand Mekontso Dessap, Islem Ouanes contributed equally to this work.

Competing interests

The author(s) declare that they have no competing interests.

Authors' contributions

AMD participated in the conception and design of the study, helped to perform the statistical analysis, and drafted the manuscript. IO participated in collection of data, helped to perform the statistical analysis, and helped to draft the manuscript. NR and BB participated in collection of data and helped to draft the manuscript. CB and AH carried out atorvastatin pharmacokinetics and helped to draft the manuscript. SK helped to perform the statistical analysis and helped to draft the manuscript. CBB participated in the conception, design and coordination of the study, and helped to draft the manuscript. All authors read and approved the final manuscript.

Abstract

Introduction

Recent publications suggest potential benefits from statins as a preventive or adjuvant therapy in sepsis. Whether ongoing statin therapy should be continued or discontinued in patients admitted in the intensive care unit (ICU) for sepsis is open to question.

Methods

We retrospectively compared patients with severe sepsis and septic shock in whom statin therapy had been discontinued or continued. The primary endpoint was the number of organ failure-free days at day 14. Secondary end-points included hospital mortality and safety. The association of statin continuation with outcome was evaluated for crude analysis and after propensity score matching and adjustment. We also measured plasma atorvastatin concentrations in a separate set of ICU septic patients continuing the drug.

Results

Patients in whom statin therapy had been continued in the ICU (n = 44) had significantly more organ failure-free days (11 [614] vs. 6 [0-12], mean difference of 2.34, 95%CI from 0.47 to 5.21, P = 0.03) as compared to others (n = 32). However, there were important imbalances between groups, with more hospital-acquired infections, more need for surgery before ICU admission, and a trend towards more septic shock at ICU admission in the discontinuation group. The significant association of statin continuation with organ failure free days found in the crude analysis did not persist after propensity-matching or multivariable adjustment: beta coefficients [95% CI] of 2.37 [-0.96 to 5.70] (P = 0.20) and 2.24 [-0.43 to 4.91] (P = 0.11) respectively. We found particularly high pre-dose and post-dose atorvastatin concentrations in ICU septic patients continuing the drug.

Conclusions

Continuing statin therapy in ICU septic patients was not associated with reduction in the severity of organ failure after matching and adjustment. In addition, the very high plasma concentrations achieved during continuation of statin treatment advocates some caution.
Zusatzmaterial
Literatur
Über diesen Artikel

Weitere Artikel der Ausgabe 4/2011

Critical Care 4/2011 Zur Ausgabe

Neu im Fachgebiet AINS

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update AINS und bleiben Sie gut informiert – ganz bequem per eMail.

Bildnachweise