Goal
Statins have immunomodulatory and peripheral anti-inflammatory properties that are
independent of their lipid-lowering action. Whether these properties reduce the risk
for developing poststroke infection is debated in clinical literature. We estimated
the risk for developing nosocomial poststroke infection based on statin exposure in
patients aged 18 or older hospitalized for ischemic stroke.
Materials and Methods
A consecutive sample of acute care hospital electronic medical records was retrospectively
analyzed. Patients were assigned to the exposed cohort either when statin use preceded
infection or statin medication was used, but no infection developed. The unexposed
cohort included patients not on statins or initiating statins after infection developed.
The association of statin exposure with infection was examined with conditional logistic
regression adjusted for poststroke infection risk factors. Cochran–Mantel–Haenszel
analyses examined the association of statin exposure and infection status within strata
of binary predictor variables that increased infection risk.
Findings
Up to 1612 records were analyzed: 1151 in the exposed cohort and 461 in the unexposed
cohort. Infection developed in 20% of the statin-exposed patients and in 41% of the
statin-unexposed patients (P < .001). Exposure to statins reduced odds for developing nosocomial infection by
58% over no exposure (adjusted odds ratio = .418, P < .001). Statins lowered the infection risk for both sexes, patients with a nasogastric
tube, and patients with dysphagia (P < .05). Statins did not change infection risk for patients with endotracheal intubation.
Conclusions
In patients with ischemic stroke and without endotracheal intubation, statin medications
were associated with reduced risk of nosocomial infections.
Key Words
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Article info
Publication history
Published online: June 09, 2016
Accepted:
May 23,
2016
Received in revised form:
May 21,
2016
Received:
January 22,
2016
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.05.033
Copyright
© 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.
