BMJ  2006;333:1123-1124 (25 November), doi:10.1136/bmj.39038.509167.1F

Letters

Statins and outcomes in patients with pneumonia

Not only healthy user bias

The first 150 words of the full text of this article appear below.

We read with interest the article on the use of statins for patients with pneumonia.¹ Although an important addition to the literature, several issues limit this article's usefulness.

The choice of an outcome measure combining in-hospital mortality and admission to intensive care is curious for a prospective study with such a rich clinical database. Previous research shows that 30 day mortality is largely pneumonia related,² and from our recent study,³ 33% of deaths were after discharge and before 30 days. A preferred way to examine the impact of statins on sepsis would be to examine sepsis-related outcomes (vasopressor use, incidence of severe sepsis, or mortality alone).

The findings that age >65 years, ischaemic heart disease, and using levofloxacin are protective, or that PSI ⁴ class III has an odds ratio of 2.45, have not been previously reported and seem implausible. Inclusion of younger subjects who are less often prescribed statins, and . . . [Full text of this article]

¹ University of Texas Health Science Center at San Antonio, 7400 Merton Minter Boulevard (11C6), San Antonio, TX 78229, USA

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Relevant Article

Statins and outcomes in patients admitted to hospital with community acquired pneumonia: population based prospective cohort study

Sumit R Majumdar, Finlay A McAlister, Dean T Eurich, Raj S Padwal, and Thomas J Marrie
BMJ 2006 333: 999. [Abstract] [Full Text] [PDF]