Association between statin administration and Clostridium difficile-induced enteritis: a retrospective analysis of the MIMIC-IV database

他汀类药物治疗与艰难梭菌感染性肠炎之间的关联:MIMIC-IV数据库的回顾性分析

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Abstract

BACKGROUND: Existing research suggests that using statins may reduce the incidence of enteritis caused by C. difficile and improve the prognosis of patients. This study aimed to explore the relation between Clostridium difficile-induced enteritis (CDE) and statin use. METHODS: Data were collected from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database. Multivariate logistic regression analysis was employed to assess the impact of statin use on CDE incidence in patients in intensive care units (ICUs) and its effect on in-hospital mortality among them. The research findings were validated by performing propensity score matching (PSM), inverse probability of treatment weighting (IPTW), and subgroup analyses. RESULTS: The study enrolled the data of 51,978 individuals to assess the effect of statin usage on the occurrence of CDE in patients admitted to the ICU. The results indicate that statins can decrease the prevalence of CDE in patients in ICU (odds ratio (OR): 0.758, 95% confidence interval (CI): 0.666-0.873, P < 0.05), which was further confirmed through PSM (OR: 0.760, 95% CI: 0.661-0.873, P < 0.05) and IPTW (OR: 0.818, 95% CI: 0.754-0.888, P < 0.05) analyses. For most subgroups, statins' favorable effect in reducing CDE remained constant. A total of 1,208 patients were included in the study to evaluate whether statins could lower the risk of death in patients in ICU with enteritis caused by C. difficile. Statins did not reduce in-hospital mortality of patients in ICU with CDE (OR: 0.911, 95% CI: 0.667-1.235, P = 0.553). The results were validated following PSM (OR: 0.877, 95% CI: 0.599-1.282, P = 0.499) and IPTW (OR: 0.781, 95% CI: 0.632-1.062, P = 0.071) analyses, and all subgroups demonstrated consistent results. CONCLUSION: Statin administration can reduce the incidence of CDE in patients in the ICU; however, it does not decrease the in-hospital mortality rate for individuals with CDE.

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