Statins Improve Clinical Outcomes in Patients With Sepsis

Sepsis is a life-threatening condition that affects approximately 750,000 people annually in the U.S., with a mortality rate of around 27%. In about 15% of these cases, sepsis progresses to septic shock, a more severe state marked by dangerously low blood pressure and reduced tissue perfusion, where the risk of death increases to 30-40%.

Prompt treatment significantly improves outcomes for patients with sepsis. Standard care typically involves antibiotics, intravenous fluids, and vasopressors to stabilise blood pressure.

A recent study published in Frontiers in Immunology suggests that supplementary treatment with statins, widely used for managing cardiovascular risk, may improve survival rates in critically ill sepsis patients. Statin treatment was associated with a 39% reduction in 28-day mortality among critically ill sepsis patients.

While statins are primarily known for lowering LDL cholesterol and triglycerides while increasing HDL cholesterol, they also possess a range of beneficial properties, including anti-inflammatory, immunomodulatory, antioxidant, and antithrombotic effects. These qualities have sparked growing interest in their potential as adjunct therapies for inflammatory conditions like sepsis.

The researchers used the MIMIC-IV database, a publicly available repository of anonymised electronic health records from over 265,000 patients treated at the Beth Israel Deaconess Medical Center between 2008 and 2019. They included only adult patients diagnosed with sepsis and hospitalised for more than 24 hours. The research team matched patients who received statins with similar patients who did not, based on key clinical variables. The final analysis included 6,070 patients in each group.

The primary outcome was 28-day all-cause mortality. Results showed a mortality rate of 14.3% in the statin group versus 23.4% in the non-statin group, a relative reduction of 39%. However, patients on statins required slightly longer durations of mechanical ventilation (by about 3 hours) and continuous renal replacement therapy (by about 26 hours), suggesting a potential tradeoff between improved survival and prolonged critical care support.

These findings strongly support the idea that statins may offer protective effects and improve outcomes in sepsis. Additional analyses confirmed the mortality benefit among patients with normal, overweight, or obese BMI but not in those who were underweight.

Study researchers point out that to validate these results, an ideal randomised controlled trial would need a large sample of sepsis patients, with careful tracking of statin type, dosage, and duration. It should also account for the timing of initiation and control for possible confounding factors.

Until such trials are conducted, this new study adds to the growing evidence that statins, beyond their cardiovascular role, may hold promise as an adjunctive therapy in the management of sepsis.

Source: Frontiers in Immunology

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