Statin Use and Hospital Length of Stay among Adults Hospitalized with Community-acquired Pneumonia

Fiona Havers, Anna M. Bramley, Lyn Finelli, Carrie Reed, Wesley H. Self, Christopher Trabue, Sherene Fakhran, Robert Balk, D. Mark Courtney, Timothy D. Girard, Evan J. Anderson, Carlos G. Grijalva, Kathryn M. Edwards, Richard G. Wunderink, Seema Jain

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    Abstract

    Background. Prior retrospective studies suggest that statins may benefit patients with community-acquired pneumonia (CAP) due to antiinflammatory and immunomodulatory effects. However, prospective studies of the impact of statins on CAP outcomes are needed. We determined whether statin use was associated with improved outcomes in adults hospitalized with CAP. Methods. Adults aged ≥18 years hospitalized with CAP were prospectively enrolled at 3 hospitals in Chicago, Illinois, and 2 hospitals in Nashville, Tennessee, from January 2010 - June 2012. Adults receiving statins before and throughout hospitalization (statin users) were compared with those who did not receive statins (nonusers). Proportional subdistribution hazards models were used to examine the association between statin use and hospital length of stay (LOS). In-hospital mortality was a secondary outcome. We also compared groups matched on propensity score. Results. Of 2016 adults enrolled, 483 (24%) were statin users; 1533 (76%) were nonusers. Statin users were significantly older, had more comorbidities, had more years of education, and were more likely to have health insurance than nonusers. Multivariable regression demonstrated that statin users and nonusers had similar LOS (adjusted hazard ratio [HR], 0.99; 95% confidence interval [CI],. 88-1.12), as did those in the propensity-matched groups (HR, 1.03; 95% CI,. 88-1.21). No significant associations were found between statin use and LOS or in-hospital mortality, even when stratified by pneumonia severity. Conclusions. In a large prospective study of adults hospitalized with CAP, we found no evidence to suggest that statin use before and during hospitalization improved LOS or in-hospital mortality.

    Original languageEnglish (US)
    Pages (from-to)1471-1478
    Number of pages8
    JournalClinical Infectious Diseases
    Volume62
    Issue number12
    DOIs
    StatePublished - Jun 15 2016

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    Hydroxymethylglutaryl-CoA Reductase Inhibitors
    Length of Stay
    Pneumonia
    Hospital Mortality
    Hospitalization
    Research Design
    Prospective Studies
    Confidence Intervals
    Propensity Score
    Health Insurance
    Proportional Hazards Models
    Comorbidity
    Anti-Inflammatory Agents

    All Science Journal Classification (ASJC) codes

    • Microbiology (medical)
    • Infectious Diseases

    Cite this

    Havers, F., Bramley, A. M., Finelli, L., Reed, C., Self, W. H., Trabue, C., ... Jain, S. (2016). Statin Use and Hospital Length of Stay among Adults Hospitalized with Community-acquired Pneumonia. Clinical Infectious Diseases, 62(12), 1471-1478. https://doi.org/10.1093/cid/ciw174

    Statin Use and Hospital Length of Stay among Adults Hospitalized with Community-acquired Pneumonia. / Havers, Fiona; Bramley, Anna M.; Finelli, Lyn; Reed, Carrie; Self, Wesley H.; Trabue, Christopher; Fakhran, Sherene; Balk, Robert; Courtney, D. Mark; Girard, Timothy D.; Anderson, Evan J.; Grijalva, Carlos G.; Edwards, Kathryn M.; Wunderink, Richard G.; Jain, Seema.

    In: Clinical Infectious Diseases, Vol. 62, No. 12, 15.06.2016, p. 1471-1478.

    Research output: Contribution to journalArticle

    Havers, F, Bramley, AM, Finelli, L, Reed, C, Self, WH, Trabue, C, Fakhran, S, Balk, R, Courtney, DM, Girard, TD, Anderson, EJ, Grijalva, CG, Edwards, KM, Wunderink, RG & Jain, S 2016, 'Statin Use and Hospital Length of Stay among Adults Hospitalized with Community-acquired Pneumonia', Clinical Infectious Diseases, vol. 62, no. 12, pp. 1471-1478. https://doi.org/10.1093/cid/ciw174
    Havers, Fiona ; Bramley, Anna M. ; Finelli, Lyn ; Reed, Carrie ; Self, Wesley H. ; Trabue, Christopher ; Fakhran, Sherene ; Balk, Robert ; Courtney, D. Mark ; Girard, Timothy D. ; Anderson, Evan J. ; Grijalva, Carlos G. ; Edwards, Kathryn M. ; Wunderink, Richard G. ; Jain, Seema. / Statin Use and Hospital Length of Stay among Adults Hospitalized with Community-acquired Pneumonia. In: Clinical Infectious Diseases. 2016 ; Vol. 62, No. 12. pp. 1471-1478.
    @article{106cdd3ee73444c68a1e7e0a9d27611a,
    title = "Statin Use and Hospital Length of Stay among Adults Hospitalized with Community-acquired Pneumonia",
    abstract = "Background. Prior retrospective studies suggest that statins may benefit patients with community-acquired pneumonia (CAP) due to antiinflammatory and immunomodulatory effects. However, prospective studies of the impact of statins on CAP outcomes are needed. We determined whether statin use was associated with improved outcomes in adults hospitalized with CAP. Methods. Adults aged ≥18 years hospitalized with CAP were prospectively enrolled at 3 hospitals in Chicago, Illinois, and 2 hospitals in Nashville, Tennessee, from January 2010 - June 2012. Adults receiving statins before and throughout hospitalization (statin users) were compared with those who did not receive statins (nonusers). Proportional subdistribution hazards models were used to examine the association between statin use and hospital length of stay (LOS). In-hospital mortality was a secondary outcome. We also compared groups matched on propensity score. Results. Of 2016 adults enrolled, 483 (24{\%}) were statin users; 1533 (76{\%}) were nonusers. Statin users were significantly older, had more comorbidities, had more years of education, and were more likely to have health insurance than nonusers. Multivariable regression demonstrated that statin users and nonusers had similar LOS (adjusted hazard ratio [HR], 0.99; 95{\%} confidence interval [CI],. 88-1.12), as did those in the propensity-matched groups (HR, 1.03; 95{\%} CI,. 88-1.21). No significant associations were found between statin use and LOS or in-hospital mortality, even when stratified by pneumonia severity. Conclusions. In a large prospective study of adults hospitalized with CAP, we found no evidence to suggest that statin use before and during hospitalization improved LOS or in-hospital mortality.",
    author = "Fiona Havers and Bramley, {Anna M.} and Lyn Finelli and Carrie Reed and Self, {Wesley H.} and Christopher Trabue and Sherene Fakhran and Robert Balk and Courtney, {D. Mark} and Girard, {Timothy D.} and Anderson, {Evan J.} and Grijalva, {Carlos G.} and Edwards, {Kathryn M.} and Wunderink, {Richard G.} and Seema Jain",
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    TY - JOUR

    T1 - Statin Use and Hospital Length of Stay among Adults Hospitalized with Community-acquired Pneumonia

    AU - Havers, Fiona

    AU - Bramley, Anna M.

    AU - Finelli, Lyn

    AU - Reed, Carrie

    AU - Self, Wesley H.

    AU - Trabue, Christopher

    AU - Fakhran, Sherene

    AU - Balk, Robert

    AU - Courtney, D. Mark

    AU - Girard, Timothy D.

    AU - Anderson, Evan J.

    AU - Grijalva, Carlos G.

    AU - Edwards, Kathryn M.

    AU - Wunderink, Richard G.

    AU - Jain, Seema

    PY - 2016/6/15

    Y1 - 2016/6/15

    N2 - Background. Prior retrospective studies suggest that statins may benefit patients with community-acquired pneumonia (CAP) due to antiinflammatory and immunomodulatory effects. However, prospective studies of the impact of statins on CAP outcomes are needed. We determined whether statin use was associated with improved outcomes in adults hospitalized with CAP. Methods. Adults aged ≥18 years hospitalized with CAP were prospectively enrolled at 3 hospitals in Chicago, Illinois, and 2 hospitals in Nashville, Tennessee, from January 2010 - June 2012. Adults receiving statins before and throughout hospitalization (statin users) were compared with those who did not receive statins (nonusers). Proportional subdistribution hazards models were used to examine the association between statin use and hospital length of stay (LOS). In-hospital mortality was a secondary outcome. We also compared groups matched on propensity score. Results. Of 2016 adults enrolled, 483 (24%) were statin users; 1533 (76%) were nonusers. Statin users were significantly older, had more comorbidities, had more years of education, and were more likely to have health insurance than nonusers. Multivariable regression demonstrated that statin users and nonusers had similar LOS (adjusted hazard ratio [HR], 0.99; 95% confidence interval [CI],. 88-1.12), as did those in the propensity-matched groups (HR, 1.03; 95% CI,. 88-1.21). No significant associations were found between statin use and LOS or in-hospital mortality, even when stratified by pneumonia severity. Conclusions. In a large prospective study of adults hospitalized with CAP, we found no evidence to suggest that statin use before and during hospitalization improved LOS or in-hospital mortality.

    AB - Background. Prior retrospective studies suggest that statins may benefit patients with community-acquired pneumonia (CAP) due to antiinflammatory and immunomodulatory effects. However, prospective studies of the impact of statins on CAP outcomes are needed. We determined whether statin use was associated with improved outcomes in adults hospitalized with CAP. Methods. Adults aged ≥18 years hospitalized with CAP were prospectively enrolled at 3 hospitals in Chicago, Illinois, and 2 hospitals in Nashville, Tennessee, from January 2010 - June 2012. Adults receiving statins before and throughout hospitalization (statin users) were compared with those who did not receive statins (nonusers). Proportional subdistribution hazards models were used to examine the association between statin use and hospital length of stay (LOS). In-hospital mortality was a secondary outcome. We also compared groups matched on propensity score. Results. Of 2016 adults enrolled, 483 (24%) were statin users; 1533 (76%) were nonusers. Statin users were significantly older, had more comorbidities, had more years of education, and were more likely to have health insurance than nonusers. Multivariable regression demonstrated that statin users and nonusers had similar LOS (adjusted hazard ratio [HR], 0.99; 95% confidence interval [CI],. 88-1.12), as did those in the propensity-matched groups (HR, 1.03; 95% CI,. 88-1.21). No significant associations were found between statin use and LOS or in-hospital mortality, even when stratified by pneumonia severity. Conclusions. In a large prospective study of adults hospitalized with CAP, we found no evidence to suggest that statin use before and during hospitalization improved LOS or in-hospital mortality.

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    U2 - 10.1093/cid/ciw174

    DO - 10.1093/cid/ciw174

    M3 - Article

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    SP - 1471

    EP - 1478

    JO - Clinical Infectious Diseases

    JF - Clinical Infectious Diseases

    SN - 1058-4838

    IS - 12

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