• Eric M Mortensen, Marcos I Restrepo, Laurel A Copeland, Jacqueline A Pugh, Antonio Anzueto, John E Cornell, and Mary Jo V Pugh.
• VERDICT Research Center, South Texas Veterans Health Care System, San Antonio, Texas 78284, USA. mortensene@uthscsa.edu
• Pharmacotherapy. 2007 Dec 1; 27 (12): 1619-26.

Study ObjectiveTo examine the effect of previous outpatient use of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) and/or angiotensin II receptor blockers (ARBs) on 30-day mortality in patients hospitalized with sepsis.DesignRetrospective national cohort study.Data SourceDepartment of Veterans Affairs (VA) national patient care and pharmacy databases.PatientsA total of 3018 patients who were hospitalized with sepsis in fiscal year 2000, had at least 1 year of previous VA outpatient care, and had at least one active and filled VA prescription within 90 days of admission.Measurements And Main ResultsThe primary outcome was 30-day mortality. The primary analysis was a multilevel model with hospital as a random effect and control variables that included comorbid conditions, demographics, and other drugs. Among the 3018 patients hospitalized with sepsis, mean age was 74.4 years, 2975 (98.6%) were male, and 811 (26.9%) died within 30 days of admission. Regarding prescription drug use, 480 patients (15.9%) were taking statins and 107 (3.5%) were taking ARBs. After adjusting for potential confounders, statin use (odds ratio [OR] 0.48, 95% confidence interval [CI] 0.36-0.64) and ARB use (OR 0.42, 95% CI 0.24-0.76) were significantly associated with decreased 30-day mortality.ConclusionsUse of statins and/or ARBs before admission was associated with decreased mortality in patients hospitalized with sepsis. Further research is needed to determine if these drugs might be started on admission for those with sepsis.

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