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Statin use and risk of community acquired pneumonia in older people: population based case-control study.

Dublin S, Jackson ML, Nelson JC, Weiss NS, Larson EB, Jackson LA - BMJ (2009)

Bottom Line: To test the hypothesis that hydroxymethyl glutaryl coenzyme A reductase inhibitors (statins) may decrease the risk of community acquired pneumonia.Among cases admitted to hospital and matched controls, current statin use was present in 17.2% (68/395) of cases and 14.2% (112/788) of controls (adjusted odds ratio 1.61, 1.08 to 2.39, compared with non-use).Statin use was not associated with decreased risk of pneumonia among immunocompetent, community dwelling older people.

View Article: PubMed Central - PubMed

Affiliation: Group Health Center for Health Studies, 1730 Minor Avenue, Suite 1600, Seattle WA 98101-1448, USA. dublin.s@ghc.org

ABSTRACT

Objective: To test the hypothesis that hydroxymethyl glutaryl coenzyme A reductase inhibitors (statins) may decrease the risk of community acquired pneumonia.

Design: Population based case-control study.

Setting: Group Health, a large integrated healthcare delivery system. Population Immunocompetent, community dwelling Group Health members aged 65 to 94; two matched controls for each case with pneumonia. Information on comorbid illnesses and functional and cognitive status, potential confounders of the association between statin use and risk of pneumonia, came from medical record review and computerised pharmacy data.

Main outcome measure: Adjusted estimates of risk of pneumonia in relation to current statin use.

Results: 1125 validated cases of pneumonia and 2235 matched controls were identified. Compared with controls, cases were more likely to have chronic lung and heart disease, especially severe disease, and functional or cognitive impairment. Current statin use was present in 16.1% (181/1125) of cases and 14.6% (327/2235) of controls (adjusted odds ratio 1.26, 95% confidence interval 1.01 to 1.56). Among cases admitted to hospital and matched controls, current statin use was present in 17.2% (68/395) of cases and 14.2% (112/788) of controls (adjusted odds ratio 1.61, 1.08 to 2.39, compared with non-use). In people in whom statins were indicated for secondary prevention, the adjusted odds ratio for risk of pneumonia in relation to current statin use was 1.25 (0.94 to 1.67); in those with no such indication, it was 0.81 (0.46 to 1.42).

Conclusions: Statin use was not associated with decreased risk of pneumonia among immunocompetent, community dwelling older people. Findings of previous studies may reflect "healthy user" bias.

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Related in: MedlinePlus

Fig 1 Selection of cases and controls for inclusion in study
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fig1: Fig 1 Selection of cases and controls for inclusion in study

Mentions: The methods used to identify and validate pneumonia cases have been described in detail.38 Briefly, we identified presumptive cases by using ICD-9 (international classification of diseases, ninth revision) codes from inpatient and outpatient encounters (pneumonia codes: 480 to 487.0 or 507.0) and validated them through review of chest radiograph reports and hospital records. We excluded cases of nosocomial pneumonia or massive aspiration. Because the original study focused on influenza vaccination and pneumonia risk, it included pneumonia cases occurring from 1 September until the end of the influenza season in each study year (2000-1, 2001-2, and 2002-3). For people with multiple episodes of pneumonia, we included only the first episode. Figure 1 shows the flow of potential participants through the study.


Statin use and risk of community acquired pneumonia in older people: population based case-control study.

Dublin S, Jackson ML, Nelson JC, Weiss NS, Larson EB, Jackson LA - BMJ (2009)

Fig 1 Selection of cases and controls for inclusion in study
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2697311&req=5

fig1: Fig 1 Selection of cases and controls for inclusion in study
Mentions: The methods used to identify and validate pneumonia cases have been described in detail.38 Briefly, we identified presumptive cases by using ICD-9 (international classification of diseases, ninth revision) codes from inpatient and outpatient encounters (pneumonia codes: 480 to 487.0 or 507.0) and validated them through review of chest radiograph reports and hospital records. We excluded cases of nosocomial pneumonia or massive aspiration. Because the original study focused on influenza vaccination and pneumonia risk, it included pneumonia cases occurring from 1 September until the end of the influenza season in each study year (2000-1, 2001-2, and 2002-3). For people with multiple episodes of pneumonia, we included only the first episode. Figure 1 shows the flow of potential participants through the study.

Bottom Line: To test the hypothesis that hydroxymethyl glutaryl coenzyme A reductase inhibitors (statins) may decrease the risk of community acquired pneumonia.Among cases admitted to hospital and matched controls, current statin use was present in 17.2% (68/395) of cases and 14.2% (112/788) of controls (adjusted odds ratio 1.61, 1.08 to 2.39, compared with non-use).Statin use was not associated with decreased risk of pneumonia among immunocompetent, community dwelling older people.

View Article: PubMed Central - PubMed

Affiliation: Group Health Center for Health Studies, 1730 Minor Avenue, Suite 1600, Seattle WA 98101-1448, USA. dublin.s@ghc.org

ABSTRACT

Objective: To test the hypothesis that hydroxymethyl glutaryl coenzyme A reductase inhibitors (statins) may decrease the risk of community acquired pneumonia.

Design: Population based case-control study.

Setting: Group Health, a large integrated healthcare delivery system. Population Immunocompetent, community dwelling Group Health members aged 65 to 94; two matched controls for each case with pneumonia. Information on comorbid illnesses and functional and cognitive status, potential confounders of the association between statin use and risk of pneumonia, came from medical record review and computerised pharmacy data.

Main outcome measure: Adjusted estimates of risk of pneumonia in relation to current statin use.

Results: 1125 validated cases of pneumonia and 2235 matched controls were identified. Compared with controls, cases were more likely to have chronic lung and heart disease, especially severe disease, and functional or cognitive impairment. Current statin use was present in 16.1% (181/1125) of cases and 14.6% (327/2235) of controls (adjusted odds ratio 1.26, 95% confidence interval 1.01 to 1.56). Among cases admitted to hospital and matched controls, current statin use was present in 17.2% (68/395) of cases and 14.2% (112/788) of controls (adjusted odds ratio 1.61, 1.08 to 2.39, compared with non-use). In people in whom statins were indicated for secondary prevention, the adjusted odds ratio for risk of pneumonia in relation to current statin use was 1.25 (0.94 to 1.67); in those with no such indication, it was 0.81 (0.46 to 1.42).

Conclusions: Statin use was not associated with decreased risk of pneumonia among immunocompetent, community dwelling older people. Findings of previous studies may reflect "healthy user" bias.

Show MeSH
Related in: MedlinePlus