Meta-Analysis
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Meta-Anal. Aug 26, 2014; 2(3): 91-97
Published online Aug 26, 2014. doi: 10.13105/wjma.v2.i3.91
Role of statin on mortality outcome in pneumonia patients: A meta-analysis
Lekha Saha, Narinder Kumar, Pratibha Khosla, Sharonjeet Kaur
Lekha Saha, Pratibha Khosla, Sharonjeet Kaur, Department of Pharmacology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
Narinder Kumar, Department of Statistics, Panjab University, Chandigarh 160014, India
Author contributions: Saha L, Khosla P and Kaur S were equally involved in planning, data extraction, calculating and writing the manuscript; Kumar N is involved in data extraction, statistical analysis and writing of the manuscript.
Correspondence to: Dr. Lekha Saha, Assistant Professor, Department of Pharmacology, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, India. lekhasaha@rediffmail.com
Telephone: +91-172-2645262 Fax: +91-172-2744401
Received: March 11, 2014
Revised: May 23, 2014
Accepted: June 18, 2014
Published online: August 26, 2014
Abstract

AIM: To determine the role of statin on mortality outcome in patient with pneumonia.

METHODS: For the present meta-analysis, we search the published literatures online through PubMed, Embase, Scopus and the Cochrane Library databases and the search words used were “statins’”, “bacteraemia”, “pneumonia”, and “ICU infections”. During the online search our focus was on full text articles, peer-reviewed, observational cohort or case control studies and randomized controlled trials. Those studies were selected whose outcome was hospital mortality among patients with pneumonia whether or not on statins. In this meta-analysis, 30 d mortality was used as the primary outcome as it has been demonstrated in the previous research that 30 d mortality is primarily because of community acquired pneumonia. As all studies were observational, where statin users were compared with historical rather than randomized controls, odds ratio for in-hospital or all-cause 30 d mortality was used as the primary effect measure used in the meta-analysis.

RESULTS: We came across the total 25 studies comprising 35355 patients (2734 statin users and 32621 statin non-users) during the electronic search. Four studies out of 25 were included in the final analysis. In this meta-analysis, when data regarding the use of statin in pneumonia patients on mortality was pooled, its results showed the non-significant effect of the statin on mortality outcome.

CONCLUSION: Although statins seems to be useful in the treatment of pneumonia patients but for statistical conclusion, further randomized controlled trials needs to be done or their results still waited to be published of ongoing trials, with the conclusion that presently statins showing no clinical benefit in the pneumonia patients.

Keywords: Mortality, Pneumonia, Statin, Meta-analysis

Core tip: The relation between statin treatment and improvement in outcomes in patients with pneumonia have been reported in published literatures. This is believed to be due to anti-inflammatory and immunoregulatory effects rather than an effect on cholesterol metabolism. Recently, however, the potential benefit of statins has been called into question and the study has suggested that there may be confounding factor responsible for the observed benefit. All the studies were observational. In this present meta-analysis of randomized controlled trials, results showed the non-significant effect of the statin on mortality outcome.