The effect of statins on mortality from severe infections and sepsis: A systematic review and meta-analysis

Purpose The aim of these study was to systematically review the literature on the effect of stains Materials and Methods MI DI INI I MBASI Piperslarsi and the Cochrane collaboration and the Cochrane Register of controlled trials were searched and were current as of December 2009 Randomized double blind placebo controlled studies observational cohort studies (retrospective and prospective) and case controlled studies were included Types of Participants included adult and pediatric subjects with sepsis or various other types of infection Exposure was defined as the use of a statin for any indication The primary outcome chosen was mortality from any cause and secondary outcomes included 30 day mortality from mixed infection Results A total of 20 studies were included in the analysis 18 being cohort studies (12 retrospective 6 prospective) 1 matched cohort study with 2 case control studies and 1 randomized control trial Men analysis for various infection related outcomes revealed the following pooled odds ratios all in favor of statin users not 0 61 (95% confidence interval [Cl] 0 48 0 73) for 30 day meitility (n = 7) 0 38 (95% CE 0 1, 0 4) for in hospital mortality (n = 7) 0 63 (95% CI 0 55 0 71) for pneumoni related mortality (n = 4) and 0 50 (95% CI 0 18 0 83) for mixed infection related mortality (n = 4) Conclusions This meti analysis demonstrated protective effect for statins in patients with sepsis and/or other infections compared to placebo for various infection related outcomes However out results are limited by the cohort design of the selected studies and the degree of heterogencity among them and result further randomized trials are needed to valid the use of stains for sepsis and/or other infections (C) 2010 Elsevier Inc All rights reserved