Published Online
on August 2, 2004

A more recent version of this article appeared on August 17, 2004

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Submitted on May 19, 2004
Revised on June 17, 2004
Accepted on June 22, 2004

Prior Statin Therapy Is Associated With a Decreased Rate of Severe Sepsis

Yaniv Almog MD^*, Alexander Shefer MD, Victor Novack MD, Nimrod Maimon MD, Leonid Barski MD, Miruna Eizinger MD, Michael Friger PhD, Lior Zeller MD, and Abraham Danon MD, PhD

From the Medical Intensive Care Unit (Y.A., A.S., N.M.) and Departments of Medicine (V.N., L.B., M.E., L.Z.), Epidemiology (V.N., M.F.), and Clinical Pharmacology (A.D.), Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University, Beer-Sheva, Israel.

^* To whom correspondence should be addressed. E-mail: almogya{at}bgumail.bgu.ac.il.

Background--Statins have anti-inflammatory properties that are independent of their lipid-lowering abilities. We hypothesized that statin therapy before the onset of an acute bacterial infection may have a protective effect against severe sepsis. The aim of this study was to determine whether patients treated with statins develop severe sepsis less frequently.

Methods and Results--In this prospective observational cohort study, consecutive patients admitted with presumed or documented acute bacterial infection were enrolled. The primary outcomes were the rate of severe sepsis and intensive care unit (ICU) admission. Of the 361 patients enrolled, 82 (22.7%) were treated with statins before their admission. Both groups had a similar severity of illness on admission. Severe sepsis developed in 19% of patients in the no-statin group and in only 2.4% of the statin group (P<0.001). Statin treatment was associated with a relative risk of developing severe sepsis of 0.13 (95% CI, 0.03 to 0.52) and an absolute risk reduction of 16.6%. The overall ICU admission rate was 10.2% (37/361): 12.2% of the no-statin group required ICU admission, whereas in the statin group only 3.7% were admitted to the ICU (P=0.025), reflecting a relative risk of ICU admission of 0.30 (95% CI, 0.1 to 0.95).

Conclusions--Prior therapy with statins may be associated with a reduced rate of severe sepsis and ICU admission. If supported by prospective controlled trials, statins may have a role in the primary prevention of sepsis.

Key words: sepsis • anticholesterolemic agents • inflammation • primary prevention

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