Prior statin use and the outcomes in patients with first-attack acute pancreatitis: A retrospective cohort study

• Statins do not have beneficial effects on the clinical outcomes of first-attack AP.
• cDDD failed to objectively demonstrate the dose–response relationship.
• Statins have a positive effect on the CTSI in patients with a first-attack of AP.

BackgroundWe investigated whether prior stain use before admission for a first-attack AP would reduce the severity and mortality rate of a first-attack of AP with a dose–response relationship.MethodsWe conducted a retrospective cohort study from a tertiary medical center's database in Taiwan. We evaluated the dose–response relationship between statin use and the first-attack of AP by defining the daily dose (DDD). The cumulative DDD (cDDD) was calculated as the sum of the dispensed DDD of any specific statin. The outcome measures in our study included the hospital mortality rate, duration of hospitalization, Ranson's score, computed tomography severity index (CTSI), and C-reactive protein (CRP) level.ResultsIn our study, we enrolled 31 patients in statin group and 63 matched patients in control group. In the univariate analysis there was no significant difference between them with regard to the outcomes except the CTSI and serum calcium concentration. According to multivariate analysis the serum calcium concentration was significantly higher in the statin group, and the CTSI was lower in the statin group. In subgroup analysis we divided the statin group into two groups according to the cDDDs (< 365 days and > 365 days) and the results showed no significance in the demographic data, overall mortality rate, hospitalization days, CRP level, Ranson's score, or CTSI.ConclusionOur study rejected the hypothesis that statins have beneficial effects on the clinical outcomes of patients with a first-attack of AP. However we demonstrated that statins have a positive effect on the CTSI.