Impact of statins on short and long term mortality in severe community acquired pneumonia in the intensive care unit

Journal article

Severe community-acquired pneumonia (sCAP) carries high mortality. While co-adjuvant therapies remain limited, statins have shown potential benefits. This study simulated a randomised controlled trial (RCT) using real-world data to evaluate the effect of statins on mortality in ICU patients with sCAP. A propensity score matching (PSM) analysis was conducted using the MIMIC-IV database. Kaplan-Meier curves evaluated the impact of statin therapy on 28-, 90-, and 365-day mortality, and Cox regression was used to confirm associations. A total of 4,742 patients met inclusion criteria, including 1,273 who received statins before and/or during the sCAP episode. PSM achieved balanced baseline characteristics between groups. Statin therapy was associated with reduced mortality: average treatment effect − 4.03% (95% CI: -6.9% to -1.0%, p = 0.007) using PSM and − 3.7% (95% CI: -6.1% to -1.3%, p = 0.002) via inverse probability weighting. Kaplan-Meier analysis showed significantly improved survival for statin users (log-rank p < 0.0001). Cox regression confirmed a protective effect (hazard ratio 0.79, 95% CI: 0.72–0.87, p = 0.0001). Statin use was associated with reduced acute and long-term mortality in patients with sCAP. These findings highlight the potential role of statins as co-adjuvant therapy, supporting further investigation to optimise treatment protocols.

Authors: Olivella-Gomez, J; Sanabria-Herrera, N; Garcia-Gallo, E; Duque, S; Luna, D

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Nature Research
• Journal: Scientific Reports
• Volume: 15
• Issue: 1
• Article number: 41212
• Publication date: 2025-11-21
• Acceptance date: 2025-10-17
• DOI: 10.1038/s41598-025-25066-5
• EISSN: 2045-2322
• ISSN: 2045-2322
• Language: English
• Keywords: MIMIC; Mortality; Propensity score matching; Critical care; Simulation; Pneumonia; Statin