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<p>Severe community-acquired pneumonia (sCAP) carries high mortality. While co-adjuvant therapies remain limited, statins have shown potential benefits. This study simulated a randomised controlled trial (RCT) using real-world data to evaluate the effect of statins on mortality in ICU patients with sCAP. A propensity score matching (PSM) analysis was conducted using the MIMIC-IV database. Kaplan-Meier curves evaluated the impact of statin therapy on 28-, 90-, and 365-day mortality, and Cox regression was used to confirm associations. A total of 4,742 patients met inclusion criteria, including 1,273 who received statins before and/or during the sCAP episode. PSM achieved balanced baseline characteristics between groups. Statin therapy was associated with reduced mortality: average treatment effect − 4.03% (95% CI: -6.9% to -1.0%, <i>p</i> = 0.007) using PSM and − 3.7% (95% CI: -6.1% to -1.3%, <i>p</i> = 0.002) via inverse probability weighting. Kaplan-Meier analysis showed significantly improved survival for statin users (log-rank <i>p</i> &lt; 0.0001). Cox regression confirmed a protective effect (hazard ratio 0.79, 95% CI: 0.72–0.87, <i>p</i> = 0.0001). Statin use was associated with reduced acute and long-term mortality in patients with sCAP. These findings highlight the potential role of statins as co-adjuvant therapy, supporting further investigation to optimise treatment protocols.</p>

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Impact of statins on short and long term mortality in severe community acquired pneumonia in the intensive care unit

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月21日

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  • Juan Olivella-Gomez,
  • Natalia Sanabria-Herrera,
  • Esteban Garcia-Gallo,
  • Sara Duque,
  • David Luna,
  • Henry Oliveros,
  • Andrew Conway Morris,
  • Alejandro Rodriguez,
  • Djillali Annane,
  • Ignacio Martin-Loeches,
  • Luis Felipe Reyes

摘要

Severe community-acquired pneumonia (sCAP) carries high mortality. While co-adjuvant therapies remain limited, statins have shown potential benefits. This study simulated a randomised controlled trial (RCT) using real-world data to evaluate the effect of statins on mortality in ICU patients with sCAP. A propensity score matching (PSM) analysis was conducted using the MIMIC-IV database. Kaplan-Meier curves evaluated the impact of statin therapy on 28-, 90-, and 365-day mortality, and Cox regression was used to confirm associations. A total of 4,742 patients met inclusion criteria, including 1,273 who received statins before and/or during the sCAP episode. PSM achieved balanced baseline characteristics between groups. Statin therapy was associated with reduced mortality: average treatment effect − 4.03% (95% CI: -6.9% to -1.0%, p = 0.007) using PSM and − 3.7% (95% CI: -6.1% to -1.3%, p = 0.002) via inverse probability weighting. Kaplan-Meier analysis showed significantly improved survival for statin users (log-rank p < 0.0001). Cox regression confirmed a protective effect (hazard ratio 0.79, 95% CI: 0.72–0.87, p = 0.0001). Statin use was associated with reduced acute and long-term mortality in patients with sCAP. These findings highlight the potential role of statins as co-adjuvant therapy, supporting further investigation to optimise treatment protocols.