In the Journals

Statins reduced risk for hypoxic hepatitis in ICU patients

Statin therapy received before ICU admission reduced the risk for hypoxic hepatitis, a potentially deadly complication, in critically ill patients, according to study data.

A prospective study of three ICUs at Medical University of Vienna in Austria included 851 consecutive patients (mean age, 63 years; 60% men) who had been screened for hypoxic hepatitis (HH) within 2 days of ICU admission. Fifty-five percent of the patients were admitted because of cardiogenic events and/or cardiopulmonary resuscitation or infections/sepsis.

Before admission, 155 patients (18%) had received statins for hepatic ischemia or hepatic reperfusion. Atorvastatin (45%) and simvastatin (43%) were the most commonly used drugs. Researchers documented the 28-day, 90-day, and 1-year survival rates for all patients.

Among the statin patients, 95% did not develop HH (n=147), while the other eight and 79 patients not receiving statins developed HH within 48 hours of ICU admission.

Of the study patients admitted to the ICU, 26% died within 28 days, 33% died within 90 days and the remainder died within 1 year. For each period mortality rates in HH were 58%, 67% and 74%, respectively.

In multivariate analysis, patients treated with statins before ICU admission displayed a significant association with decreased incidence of HH within 48 hours of admission (adjusted OR=0.42; 95% CI, 0.19-0.95). This effect was only significant for improved survival at 28 days (P<.05), but not 90-day or 1-year mortality.

Independent risk factors that increased the odds for HH were cardiogenic shock (aOR=6.88; 95% CI, 3.95-11.96), septic shock (aOR=3.46; 95% CI, 1.95-6.14) and active alcohol consumption (aOR=3.33; 95% CI, 1.41-7.85).

“This is the first study prospectively evaluating risk and protective factors for new onset of HH within 48 hours after ICU admission,” the researchers wrote. “Statin therapy led to a significant reduction of new onset of HH at the ICU.”

Disclosure: The researchers report no relevant financial disclosures.