Statin use and infections in Veterans with cirrhosis
Department of Quantitative Health Sciences
Adult; 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
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.
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Citation: Aliment Pharmacol Ther. 2013 Sep;38(6):611-8. doi: 10.1111/apt.12430 Link to article on publisher's site
Alimentary pharmacology and therapeutics
Motzkus-Feagans, Christine; Pakyz, A. L.; Ratliff, S. M.; Bajaj, J. S.; and Lapane, Kate L., "Statin use and infections in Veterans with cirrhosis" (2013). University of Massachusetts Medical School Faculty Publications. 463.