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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Effects of discontinuing or continuing ongoing statin therapy in severe sepsis and septic shock: A retrospective cohort study
Critical Care, Volume 15, No. 4, Article R171, Year 2011
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Description
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 67891011121314 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. © 2011 Mekontso Dessap et al.; licensee BioMed Central Ltd.
Authors & Co-Authors
Mekontso-Dessap, Armand
France, Creteil
Hôpital Henri Mondor
France, Creteil
Institut Mondor de Recherche Biomédicale
France, Creteil
Faculté de Santé
Ouanes, Islem
France, Creteil
Hôpital Henri Mondor
Tunisia, Monastir
Chu Fattouma-bourguiba
Rana, Nerlep
France, Creteil
Hôpital Henri Mondor
Borghi, Beatrice
France, Creteil
Hôpital Henri Mondor
Bazin, Christophe
France, Creteil
Hôpital Henri Mondor
Katsahian, Sandrine
France, Creteil
Hôpital Henri Mondor
Hulin, Anne
France, Creteil
Hôpital Henri Mondor
Brun-Buisson, Christian J.L.
France, Creteil
Hôpital Henri Mondor
France, Creteil
Institut Mondor de Recherche Biomédicale
France, Creteil
Faculté de Santé
Statistics
Citations: 28
Authors: 8
Affiliations: 4
Identifiers
Doi:
10.1186/cc10317
ISSN:
13648535
e-ISSN:
1466609X
Research Areas
Health System And Policy
Study Design
Cohort Study
Case-Control Study
Study Approach
Quantitative