Statin Use Is Associated With Reduced Mortality On Mechanically Ventilated Patients: A Retrospective Propensity-Matched Analysis Of MIMIC-III Database

Objective: Mechanical ventilation can cause injury and inflammatory disorders in the lungs of critically ill patients. We sought to determine whether statin treatment has a protective effect on the outcome of these patients. Methods: A retrospective observational study of ICU patients from the Medical Information Mart for Intensive Care III (MIMIC-III) database. Information on ventilated patients was analyzed using data from the MIMIC-III database. The non-statin cohort was selected using 1:1 propensity matching with the statin cohort by age, sex, severity scores and 29 other variables. Compared with nonusers, the use of statins was associated with improved 28-day survival in the unmatched cohort (HR 0.85 95% CI 0.80~0.90) and matched cohort (HR 0.72 95% CI 0.67~0.77). Statin use was also associated with improved in-hospital survival in both the unmatched cohort (HR 0.90, 95% CI 0.85~0.95) and the matched cohort (HR 0.75 95% CI 0.70~0.80). In the multivariate Cox model, the use of statins was also associated with an improvement in 28-day survival in the unmatched cohort (HR 0.73 95% CI 0.68～0.77) and in the matched cohort (HR 0.73 95% CI 0.68~0.78). The use of statins was associated with longer ICU length of stay (LOS), shorter ventilator-free days (VFDs) and fewer model for end-stage liver disease score (MELD) in the matched cohort. The subgroup analysis results showed improved 28-day survival, but this improvement was not observed in patients with pneumonia, obesity, septicemia or acute respiratory failure. Conclusions: In a population of mechanically ventilated patients, the use of statins may be associated with reduced mortality.