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Background <p>Acute kidney injury (AKI), a common complication in sepsis, especially for obese patients, is linked to increased morbidity and mortality. Statins, known for their lipid-lowering effects, also exhibit anti-inflammatory and immunomodulatory properties, suggesting potential benefits in sepsis and AKI.</p> Materials and methods <p>This retrospective cohort study leveraged data from the MIMIC-IV database. The study population was stratified into survivors and non-survivors based on in-hospital mortality. Demographic data, comorbidities, laboratory parameters, and treatment modalities were extracted. Multivariate logistic regression models were conducted to evaluate the relationship between statin use and outcomes, with adjustments for confounders. Subgroup analyses and propensity score-matching (PSM) were undertaken for further validation.</p> Results <p>In this study of 8,921 sepsis patients, pre-ICU statin use was associated with significantly improved outcomes. Univariate analysis showed that statin use reduced the risk of AKI by 69% (OR = 0.31, 95% CI 0.27–0.44, <i>p</i> &lt; 0.001) and decreased in-hospital mortality by 57% (OR = 0.43, 95% CI 0.22–0.54, <i>p</i> &lt; 0.001). Multivariate regression confirmed the robustness of these findings, with fully adjusted models demonstrating a 31% reduction in AKI (OR = 0.67, <i>p</i> &lt; 0.001) and a 22% reduction in mortality (OR = 0.67, <i>p</i> &lt; 0.001). Subgroup and propensity score-matched analyses further supported these associations, showing consistent protective effects across patient subgroups and a reduction in both AKI and mortality.</p> Conclusion <p>Pre-ICU statin therapy is associated with a lower risk of AKI and improved in-hospital survival among obese patients with sepsis, suggesting its potential role as a protective measure in this high-risk population.</p>

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Association between pre-ICU statin use and acute kidney injury and in hospital mortality in obese patients with sepsis

  • 期刊论文

  • 发表日期：

    2025年2月28日

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  • Xuanxuan Xiong,
  • Yangqingqing Liu

摘要

Background

Acute kidney injury (AKI), a common complication in sepsis, especially for obese patients, is linked to increased morbidity and mortality. Statins, known for their lipid-lowering effects, also exhibit anti-inflammatory and immunomodulatory properties, suggesting potential benefits in sepsis and AKI.

Materials and methods

This retrospective cohort study leveraged data from the MIMIC-IV database. The study population was stratified into survivors and non-survivors based on in-hospital mortality. Demographic data, comorbidities, laboratory parameters, and treatment modalities were extracted. Multivariate logistic regression models were conducted to evaluate the relationship between statin use and outcomes, with adjustments for confounders. Subgroup analyses and propensity score-matching (PSM) were undertaken for further validation.

Results

In this study of 8,921 sepsis patients, pre-ICU statin use was associated with significantly improved outcomes. Univariate analysis showed that statin use reduced the risk of AKI by 69% (OR = 0.31, 95% CI 0.27–0.44, p < 0.001) and decreased in-hospital mortality by 57% (OR = 0.43, 95% CI 0.22–0.54, p < 0.001). Multivariate regression confirmed the robustness of these findings, with fully adjusted models demonstrating a 31% reduction in AKI (OR = 0.67, p < 0.001) and a 22% reduction in mortality (OR = 0.67, p < 0.001). Subgroup and propensity score-matched analyses further supported these associations, showing consistent protective effects across patient subgroups and a reduction in both AKI and mortality.

Conclusion

Pre-ICU statin therapy is associated with a lower risk of AKI and improved in-hospital survival among obese patients with sepsis, suggesting its potential role as a protective measure in this high-risk population.