Statin Therapy and Mortality from Sepsis: A Meta-analysis of Randomized Trials

BACKGROUND: Statin therapy for sepsis has been suggested by observational studies. However, randomized controlled trials have not demonstrated this benefit. We conducted a systematic review and meta-analysis of randomized trials to evaluate the effect of statin therapy on mortality in patients with sepsis. METHODS: We searched 6 electronic databases for articles published before August 2014. Randomized trials reporting the effect of statin therapy on mortality in patients with sepsis were included. The primary outcome of interest was in-hospital or 28-day mortality. Two independent reviewers searched and identified studies and extracted data. Risk ratios (RRs) were pooled across studies using random-effects models and were verified using fixed-effects models. RESULTS: Seven randomized trials were included in the analyses, comprising 1720 patients. Statin therapy did not significantly decrease in-hospital mortality (RR, 1.04; 95% confidence interval, 0.87-1.24; I-2 = 0%; P = .68) or 28-day mortality (RR, 0.93; 95% confidence interval, 0.46-1.89; I-2 = 57%; P = .85) in patients with sepsis. Study quality of the included trials was high; the median Jadad score was 4.5 (range, 4-5). CONCLUSIONS: This systematic review and meta-analysis of randomized trials suggests that statin therapy does not improve mortality outcomes in patients with sepsis compared with placebo. (C) 2015 Elsevier Inc. All rights reserved.