Statin use and infections in Veterans with cirrhosis
Motzkus-Feagans, Christine ; Pakyz, A. L. ; Ratliff, S. M. ; Bajaj, J. S. ; Lapane, Kate L
Citations
Student Authors
Faculty Advisor
Academic Program
UMass Chan Affiliations
Document Type
Publication Date
Keywords
Aged
Aged, 80 and over
Anti-Infective Agents
Clostridium difficile
Enterocolitis, Pseudomembranous
Female
Hospitals, Veterans
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Liver Cirrhosis
Male
Metronidazole
Middle Aged
Military Personnel
Proportional Hazards Models
Recurrence
Retrospective Studies
Risk Factors
Treatment Outcome
United States
Digestive System Diseases
Hepatology
Therapeutics
Subject Area
Embargo Expiration Date
Link to Full Text
Abstract
BACKGROUND: Evidence about the beneficial effects of statins on reducing infections is accumulating. Identifying ways to reduce infection risk in patients with cirrhosis is important because of increased mortality risk and costs associated with infections.
AIM: To estimate the extent to which statin use prolongs time to infection among patients with cirrhosis.
METHODS: We identified Veterans with cirrhosis, but without decompensation (n = 19,379) using US Veterans Health Administration data from 2001 to 2009. New users of statins were identified and propensity matched to non-users and users of other cholesterol-lowering medications (1:1 matching). The cohort was followed up for hospitalisations with infections. Cox regression models with time-varying exposures provided estimates of adjusted hazard ratios (HR) and 95% confidence intervals (CI).
RESULTS: New statin use was present among 13% of VA patients with cirrhosis without decompensation. Overall, 12.4% of patients developed a serious infection, and 0.1% of patients died. In the propensity-matched sample, statin users experienced hospitalisations with infections at a rate 0.67 less than non-users (95% Confidence Interval: 0.47-0.95).
CONCLUSIONS: Infections are a major concern among cirrhotic patients and have the potential to seriously impact both life expectancy and quality of life. Statin use may potentially reduce the risk of infections among patients with cirrhosis.
Source
Aliment Pharmacol Ther. 2013 Sep;38(6):611-8. doi: 10.1111/apt.12430 Link to article on publisher's site