Effects of Statins on the Incidence and Mortality of Sepsis in Patients with New Cancer Diagnosis
Abstract
:1. Introduction
2. Methods
Statistical Analysis
3. Results
3.1. Effect of Statin Use on Overall Survival
3.2. Effect of Statin Use on the Incidence of Sepsis
3.3. Effect of Statin Use on Sepsis Mortality
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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No Statin (n = 99,911) | Statin (n = 19,468) | Total (n = 119,379) | p Value | |
---|---|---|---|---|
Female, n (%) | 63,174 (63.2%) | 9758 (50.1%) | 72,932 (61.1%) | <0.001 |
Age, years | 54 (49–59) | 58 (54–61) | 55 (50–60) | <0.001 |
Comorbidities: | ||||
Myocardial infarction, n (%) | 478 (0.5%) | 459 (2.4%) | 937 (0.8%) | <0.001 |
Congestive heart failure, n (%) | 1126 (1.1%) | 539 (2.8%) | 1665 (1.4%) | <0.001 |
Peripheral vascular disease, n (%) | 2010 (2.0%) | 990 (5.1%) | 3000 (2.5%) | <0.001 |
Cerebrovascular disease, n (%) | 2212 (2.2%) | 1091 (5.6%) | 3303 (2.8%) | <0.001 |
Chronic pulmonary disease, n (%) | 10,222 (10.2%) | 2462 (12.6%) | 12,684 (10.6%) | <0.001 |
Renal disease, n (%) | 1265 (1.3%) | 574 (2.9%) | 1839 (1.5%) | <0.001 |
Modified Charlson comorbidity index risk, n (%) | <0.001 | |||
mCCI = 0 | 68,540 (70.5%) | 9454 (48.7%) | 77,994 (66.9%) | |
mCCI 1–2 | 25,773 (26.5%) | 8605 (44.3%) | 34,378 (29.5%) | |
mCCI 3–4 | 2162 (2.2%) | 1121 (5.8%) | 3283 (2.8%) | |
mCCI ≥ 5 | 723 (0.7%) | 226 (1.2%) | 949 (0.8%) | |
Cancer site: | ||||
Head and neck, n (%) | 1771 (1.8%) | 407 (2.1%) | 2178 (1.8%) | 0.002 |
Gastrointestinal, n (%) | 15,728 (15.7%) | 3132 (16.1%) | 18,860 (15.8%) | 0.226 |
Lung, n (%) | 7504 (7.5%) | 1918 (9.9%) | 9422 (7.9%) | <0.001 |
Musculoskeletal and breast, n (%) | 32,556 (32.6%) | 4773 (24.5%) | 37,329 (31.3%) | <0.001 |
Genitourinary, n (%) | 13,404 (13.4%) | 3337 (17.1%) | 16,741 (14.0%) | <0.001 |
Hematological malignancy, n (%) | 9160 (9.2%) | 1790 (9.2%) | 10,950 (9.2%) | 0.907 |
Metastases, n (%) | 10,755 (10.8%) | 2027 (10.4%) | 12,782 (10.7%) | 0.145 |
Covariate | Hazard Ratio | 95% Confidence Interval | p |
---|---|---|---|
Female gender | 0.857 | 0.822–0.894 | <0.0001 |
Age | 1.023 | 1.019–1.026 | <0.0001 |
Modified Charlson comorbidity index group (0 as the reference): | |||
mCCI 1–2 | 1.392 | 1.334–1.452 | <0.0001 |
mCCI 3–4 | 1.874 | 1.711–2.052 | <0.0001 |
mCCI ≥ 5 | 2.233 | 1.918–2.560 | <0.0001 |
Cancer site (hematological malignancy as the reference): | |||
Gastrointestinal | 1.160 | 1.082–1.244 | <0.0001 |
Genitourinary | 0.405 | 0.370–0.443 | <0.0001 |
Head and neck | 0.522 | 0.435–0.626 | <0.0001 |
Musculoskeletal and breast | 0.273 | 0.250–0.297 | <0.0001 |
Lung | 2.262 | 2.105–2.432 | <0.0001 |
Statin use | 0.897 | 0.851–0.945 | <0.0001 |
Covariate | Subdistribution Hazard Ratio | 95% Confidence Interval | p |
---|---|---|---|
Female gender | 0.931 | 0.885–0.979 | 0.005 |
Age | 1.017 | 1.013–1.021 | <0.0001 |
Modified Charlson comorbidity index group (0 as the reference): | |||
mCCI 1–2 | 1.438 | 1.368–1.512 | <0.0001 |
mCCI 3–4 | 2.243 | 2.028–2.482 | <0.0001 |
mCCI ≥ 5 | 2.899 | 2.472–3.400 | <0.0001 |
Cancer site (hematological malignancy as the reference): | |||
Gastrointestinal | 0.879 | 0.817–0.946 | 0.0006 |
Genitourinary | 0.445 | 0.407–0.486 | <0.0001 |
Head and neck | 0.580 | 0.486–0.692 | <0.0001 |
Musculoskeletal and breast | 0.265 | 0.243–0.290 | <0.0001 |
Lung | 0.771 | 0.703–0.845 | <0.0001 |
Statin use | 0.990 | 0.932–1.050 | 0.73 |
Survivors (n = 5630) | Non Survivors (n = 1704) | p Value | |
---|---|---|---|
Female, n (%) | 2926 (52.0%) | 817 (47.9%) | 0.012 |
Age, years | 56 (50–59) | 57 (52–60) | <0.001 |
Comorbidities: | |||
Myocardial infarction, n (%) | 71 (1.3%) | 13 (0.8%) | 0.069 |
Congestive heart failure, n (%) | 157 (2.8%) | 51 (3.0%) | 0.130 |
Peripheral vascular disease, n (%) | 213 (3.8%) | 77 (4.5%) | 0.025 |
Cerebrovascular disease, n (%) | 176 (3.1%) | 83 (4.9%) | <0.001 |
Chronic pulmonary disease, n (%) | 776 (13.8%) | 260 (15.3%) | 0.017 |
Renal disease, n (%) | 216 (3.8%) | 61 (3.6%) | 0.056 |
Modified Charlson comorbidity index risk, n (%) | 0.299 | ||
mCCI = 0 | 3033 (55.3%) | 881 (53.6%) | |
mCCI 1–2 | 2034 (37.1%) | 613 (37.3%) | |
mCCI 3–4 | 301 (5.5%) | 108 (6.6%) | |
mCCI ≥ 5 | 114 (2.1%) | 42 (2.6%) | |
Statin use, n (%) | 1053 (18.7%) | 312 (18.3%) | 0.514 |
Cancer site: | |||
Head and neck, n (%) | 111 (2.0%) | 28 (1.6%) | 0.420 |
Gastrointestinal, n (%) | 1306 (23.2%) | 399 (23.4%) | 0.282 |
Lung, n (%) | 505 (9.0%) | 235 (13.8%) | <0.001 |
Musculoskeletal and breast, n (%) | 900 (16.0%) | 182 (10.7%) | <0.001 |
Genitourinary, n (%) | 683 (12.1%) | 152 (8.9%) | <0.001 |
Hematological malignancy, n (%) | 921 (16.4%) | 301 (17.7%) | 0.436 |
Metastases, n (%) | 775 (13.8%) | 327 (19.2%) | <0.001 |
Severe sepsis, n (%) | 943 (16.7%) | 486 (28.5%) | <0.001 |
Septic shock, n (%) | 1168 (20.7%) | 919 (53.9%) | <0.001 |
Covariate | Odds Ratio | 95% Confidence Interval | p |
---|---|---|---|
Statin use | 0.952 | 0.829–1.091 | 0.479 |
Age | 1.018 | 1.008–1.028 | <0.001 |
History of cerebrovascular disease | 1.439 | 1.071–1.920 | 0.014 |
History of myocardial infarction | 0.680 | 0.375–1.165 | 0.179 |
Cancer site (hematological malignancy as the reference): | |||
Gastrointestinal | 0.914 | 0.763–1.095 | 0.330 |
Genitourinary | 0.683 | 0.545–0.852 | <0.001 |
Head and neck | 0.629 | 0.385–0.993 | 0.055 |
Musculoskeletal and breast | 0.694 | 0.564–0.853 | <0.001 |
Lung | 1.176 | 0.944–1.464 | 0.146 |
Metastases | 1.300 | 1.106–1.526 | 0.001 |
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Van de Louw, A.; Cohrs, A.; Leslie, D. Effects of Statins on the Incidence and Mortality of Sepsis in Patients with New Cancer Diagnosis. J. Clin. Med. 2021, 10, 3427. https://doi.org/10.3390/jcm10153427
Van de Louw A, Cohrs A, Leslie D. Effects of Statins on the Incidence and Mortality of Sepsis in Patients with New Cancer Diagnosis. Journal of Clinical Medicine. 2021; 10(15):3427. https://doi.org/10.3390/jcm10153427
Chicago/Turabian StyleVan de Louw, Andry, Austin Cohrs, and Douglas Leslie. 2021. "Effects of Statins on the Incidence and Mortality of Sepsis in Patients with New Cancer Diagnosis" Journal of Clinical Medicine 10, no. 15: 3427. https://doi.org/10.3390/jcm10153427