Statin administration did not influence the progression of lung injury or associated organ failures in a cohort of patients with acute lung injury

• Published in: Intensive care medicine 2009-06, Vol.35 (6), p.1039-1046
• Main Authors: Kor, Daryl J., Iscimen, Remzi, Yilmaz, Murat, Brown, Michael J., Brown, Daniel R., Gajic, Ognjen
• Format: Article
• Language: English
• Subjects: Acute Lung Injury - prevention & control; Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Anesthesiology; Biological and medical sciences; Cohort Studies; Confidence Intervals; Critical care; Critical Care Medicine; Disease prevention; Emergency and intensive respiratory care; Emergency Medicine; Failure; Female; Hospitalization; Hospitals; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - pharmacology; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Intensive; Intensive care; Intensive care medicine; Male; Medical records; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Morbidity; Mortality; Multiple Organ Failure - prevention & control; Odds Ratio; Original; Outcome Assessment (Health Care); Pain Medicine; Patients; Pediatrics; Pneumology/Respiratory System; Respiratory distress syndrome; Retrospective Studies; Sepsis; Statins; Ventilators
• ISSN: 0342-4642; 1432-1238
• DOI: 10.1007/s00134-009-1421-8

Purpose Preclinical studies suggest that HMG-CoA reductase inhibitors (statins) may attenuate organ dysfunction. We evaluated whether statins are associated with attenuation of lung injury and prevention of associated organ failure in patients with ALI/ARDS. Methods From a database of patients with ALI/ARDS, we determined the presence and timing of statin administration. Main outcome measures were the development and progression of pulmonary and nonpulmonary organ failures as assessed by changes in PaO 2 /FiO 2 ratio and Sequential Organ Failure Assessment score (SOFA) between days 1 and 7 after the onset of ALI/ARDS. Secondary outcomes included ventilator free days, ICU and hospital mortality, and lengths of ICU and hospital stay. Results From 178 patients with ALI/ARDS, 45 (25%) received statin therapy. From day 1 to day 7, the statin group showed less improvement in their PaO 2 /FiO 2 ratio (27 vs. 55, P  = 0.042). Ventilator free days (median 21 vs. 16 days, P  = 0.158), development or progression of organ failures (median ΔSOFA 1 vs. 2, P  = 0.275), ICU mortality (20% vs. 23%, P  = 0.643), and hospital mortality (27 vs. 37%, P  = 0.207) were not significantly different in the statin and non-statin groups. After adjustment for baseline characteristics and propensity for statin administration, there were no differences in ICU or hospital lengths of stay. Conclusion In this retrospective cohort study, statin use was not associated with improved outcome in patients with ALI/ARDS. We were unable to find evidence for protection against pulmonary or nonpulmonary organ dysfunction.