Statins use and risk of mortality in patient with Clostridium difficile infection.
Clin Microbiol Infect. 2014 May 11;
Authors: Saliba W, Barnett-Griness O, Elias M, Rennert G
Current evidence suggests that statins may improve outcome in infectious diseases. This study aims to assess whether statins use is associated with reduced risk of 30-day mortality in Clostridium difficile infection (CDI). Using the computerized database of Clalit, the largest health care provider in Israel, we identified a cohort of adult subjects (age ≥40 years) who tested positive on a Clostridium difficile toxin assay performed between January-2011 and December-2012. Subjects were defined as current statins users if they filled at least one prescription during the 90 days prior to the laboratory assay date. Current users were classified into long-term users if at least one additional prescription was filled during the prior 91-180 days; otherwise they were defined as short-term users. A total 1,888 patients with CDI were included. Of them, 340 (18.0%) died during the first 30-days after diagnosis. The 30-day mortality rate was lower among current statins users 89/669 (13.3%) compared to 251/1219 (20.6%) in non-users (P<0.001). A significant reduced risk of 30-day mortality consisted after adjustment for potential confounders; adjusted OR= 0.57 (95% CI, 0.42-0.79) and was unique to long-term users; 0.53 (0.38-0.73) but not short-term users; 1.15 (0.56-2.34). The risk of 30-day mortality decreased with increasing the number of filled statins prescriptions; adjusted OR= 0.77 (0.67-0.89) for each additional prescription. Current Aspirin use was also independently associated with reduced mortality; adjusted OR= 0.64(0.43-0.88). In conclusion, current statins use, particularly long-term use, has a dose response protective effect on mortality in patients with CDI. This article is protected by copyright. All rights reserved.
PMID: 24816303 [PubMed - as supplied by publisher]