Statin Use is Associated with Reduced Mortality in Mechanically Ventilated Patients: A Retrospective Propensity-Matched Analysis of MIMIC-III Database

Abstract

Abstract Background We sought to determine whether statin treatment has a protective effect on the outcome of critically ill patients on mechanical ventilation. Methods Patients who underwent mechanical ventilation were selected from the MIMIC-III database. Patients with statin usage were allocated into the statin cohort. Patients without any statin use were matched to the statin cohort in a 1:1 ratio by propensity score. To ensure the robustness of the findings, we utilized the gradient boosted model, propensity score analysis, doubly robust estimation and an inverse probability‐weighting model in the statistical procedure. Results Before matching, 17,452 patients were enrolled in the non-statin group and 3,999 in the statin group. After matching, 3,363 patients were enrolled in each group. Compared with nonusers, the use of statins was associated with improved 28-day survival in the unmatched cohort (HR 0.85 95% CI 0.80–0.90, p < 0.01) and matched cohort (HR 0.79 95% CI 0.73–0.85, p < 0.01). Statin use was associated with longer ventilator-free days (VFD, 14.93 ± 13.11 vs 12.06 ± 13.26, p < 0.01) and longer ICU-free days (IFD, 13.41 ± 12.14 vs 10.86 ± 12.19, p < 0.01) in the matched cohort. Different types of statins were all associated with significantly improved 28-day survival. Conclusions In a population of mechanically ventilated patients, the use of statins may be associated with improved survival, longer VFDs and longer IFDs.