Statin use in cirrhotic patients with infectious diseases: A population-based study

Abstract

Background Recent studies have shown benefits of statins in patients with liver cirrhosis. However, it is still unknown if statins have a beneficial effect on the mortality of cirrhotic patients with bacterial infections. Methods The Taiwan National Health Insurance Database was searched, and 816 cirrhotic patients receiving statins with bacterial infections hospitalized between January 1, 2010 and December 31, 2013 were included in the study. A one-to-four propensity score matching was performed to select a comparison group based on age, sex, and comorbid disorders. Results The overall 30-day mortalities in statin and non-statin group were 5.3% and 9.8%, respectively (P = 0.001). After Cox regression modeling adjusting for age, sex, and comorbid disorders, the hazard ratio (HR) of statin use on 30-day mortality was 0.52 (95% confidence interval [CI]: 0.38–0.72, P<0.001). In subgroup analysis, the 30-day mortality effect of statin use was more pronounced in patients with pneumonia (HR = 0.34; 95% CI: 0.19–0.59; P<0.001) and bacteremia (HR = 0.55; 95% CI: 0.35–0.85; P = 0.008). Atovastatin (HR = 0.59; 95% CI: 0.37–0.93) and rosuvastatin (HR = 0.59; 95% CI: 0.36–0.98) were associated with a decreased 30-day mortality risk compared to patients not taking statins. Conclusions Statin use decreases the 30-day mortality of cirrhotic patients with bacteremia and pneumonia.