Clinical research studyIs Statin Use Associated with Reduced Mortality After Pneumonia? A Systematic Review and Meta-analysis
Section snippets
Information Sources and Search Strategy
We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analysis of Observational Studies in Epidemiology (MOOSE) recommendations in conducting this meta-analysis.12, 13 With the assistance of a medical research librarian, we performed serial literature searches for English and non-English articles. MEDLINE via PubMed (1950-present), EMBASE (1946-present), BIOSIS (1926-present), the Cochrane CENTRAL Register of Controlled Trials, and the Cochrane
Studies Included in the Systematic Review
Thirteen studies involving 254,950 patients published between 2005 and 2011 met inclusion criteria (Figure 1).14, 17, 18, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33 The eligible studies varied in design and included 10 cohort studies (3 prospective,24, 28, 33 7 retrospective17, 18, 25, 27, 29, 30, 32), 2 case-control studies,26, 31 and one randomized trial14 available in abstract format only (Tables 1, 2). Sample sizes of the included studies ranged from 67 to 121,254 patients. The studies were
Discussion
This meta-analysis of 13 studies finds that current statin users are less likely to die after an episode of bacterial pneumonia compared with nonstatin users. The magnitude of this benefit was similar using both unadjusted and adjusted estimates. In both analyses, the observed mortality benefit was greatest at the 30-day interval, a time-point that has been invoked as being most correlated with mortality from pneumonia.34 However, this protective effect weakened when subgroups accounting for
Acknowledgements
The authors acknowledge Drs. Dublin (Group Health Center for Health Studies and Department of Epidemiology, University of Washington, Seattle, WA), Douglas (Faculty of Epidemiology & Population Health London School of Hygiene & Tropical Medicine, London, UK), Majumdar (Department of Medicine, University of Alberta, Edmonton, AB, Canada), Meier (Basel Pharmacoepidemiology Unit, University Hospital Basel, Switzerland), and Rothberg (Center for Quality of Care Research, Baystate Medical Center,
References (44)
- et al.
Statins and sepsis: multiple modifications at multiple levels
Lancet Infect Dis
(2007) - et al.
C-reactive protein is an independent predictor of severity in community-acquired pneumonia
Am J Med
(2008) - et al.
The effect of statins on mortality from severe infections and sepsis: a systematic review and meta-analysis
J Crit Care
(2010) - et al.
Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement
Int J Surg
(2010) - et al.
Meta-analysis in clinical trials
Control Clin Trials
(1986) - et al.
Early extreme contradictory estimates may appear in published research: the Proteus phenomenon in molecular genetics research and randomized trials
J Clin Epidemiol
(2005) - et al.
Influenza and COPD mortality protection as pleiotropic, dose-dependent effects of statins
Chest
(2007) - et al.
Late admission to the ICU in patients with community-acquired pneumonia is associated with higher mortality
Chest
(2010) - et al.
Effects of guideline-concordant antimicrobial therapy on mortality among patients with community-acquired pneumonia
Am J Med
(2004) - et al.
Incidence of cardiovascular events after hospital admission for pneumonia
Am J Med
(2011)
Role of acute infection in triggering acute coronary syndromes
Lancet Infect Dis
Trends in hospitalizations for pneumonia among persons aged 65 years or older in the United States, 1988-2002
JAMA
The top 10 causes of death
Marked reduction in 30-day mortality among elderly patients with community-acquired pneumonia
Am J Med
Statins for community-acquired pneumonia: current state of the science
Eur J Clin Microbiol Infect Dis
Anti-inflammatory effects of statins: clinical evidence and basic mechanisms
Nat Rev Drug Discov
Statins for the prevention and treatment of infections: a systematic review and meta-analysis
Arch Intern Med
Statins and pneumoniaBetter evidence than can be provided by observational studies is needed to determine the association
BMJ
Effect of pravastatin on the frequency of ventilator-associated pneumonia and on intensive care unit mortality: open-label, randomized study
Crit Care Med
Meta-analysis of observational studies in epidemiology: a proposal for reportingMeta-analysis Of Observational Studies in Epidemiology (MOOSE) group
JAMA
Poster #920Presented May 16-18, 2008 International Conference, Toronto, Canada. Statin use in sepsis due to pneumonia [Abstract]
Cochrane Handbook for Systematic Reviews of Interventions
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Funding: None.
Conflict of Interest: None.
Authorship: All authors had access to the data, participated in the conception, design, writing, editing, and final approval of the manuscript.