The influence of statin exposure on inflammatory markers in XXXX with early bacterial infection: pilot prospective cohort study.

@entity1 @entity55 @entity281 @entity1850 @entity1851
BACKGROUND: In the context of @entity281 , progressive illness resulting in acute organ dysfunction is thought to be secondary to inflammatory response. Our aims were to determine risk factors for progressive @entity281 in a low-risk hospitalised cohort, including the impact of prior stain therapy. METHODS: We performed a prospective observational cohort study on two adult acute medical wards of a single tertiary academic hospital. We screened drug prescription charts of all adult acute medical admissions for inclusion criteria of inpatient administration of antibiotics for more than 24 hours for a microbiologically confirmed or clinically suspected @entity281 . @entity1 were followed until admission to a high dependency unit (HDU) or intensive care unit (ICU), discharge from hospital, or to a maximum of 10 days. Outcomes were evolution of @entity1850 ( @entity1850 ) criteria, white cell count and @entity1851 measurements, and adverse clinical outcomes. We constructed multivariable models accounting for repeated within- @entity1 measurements to determine associations between a priori selected predictors (days since admission, age, gender, Charlson score, prior statin exposure) and selected outcomes. RESULTS: We enrolled 209 @entity1 ; 27.8% were statin users and the commonest @entity281 was @entity55 (51.0%). Most (88.0%) had at least 1 @entity1850 criterion on admission, and 76 (37.3%) manifested additional @entity1850 criteria over time. Risks of admission to HDU/ICU (3.3%) and of 30-day mortality (5.7%) were low. The proportion of @entity1 with at least 1 @entity1850 criterion, mean CRP, and mean WBC all decreased over time. Multivariable regression models identified days since hospital admission as the only variable associated with daily presence of @entity1850 criteria, WCC, or @entity1851 and p < 0.0001 in all analyses). Statin exposure was not a significant predictor. CONCLUSIONS: This cohort of ward @entity1 treated for @entity281 had a low risk of clinical deterioration, inflammatory markers improved over time, and statin exposure was not associated with any outcome. Future larger studies may identify risk factors for progression of illness in this population and plausible surrogate endpoints for evaluation in clinical trials.
