http://jocmr.org/index.php/JOCMR/article/view/1333/627
Abstract
Background:
The abrupt discontinuation of statin therapy has been suggested as
being deleterious to patient outcomes. Although pre-injury statin
(PIS) therapy has been shown to have a protective effect in elderly
trauma patients, no study has examined how this population is
affected by its abrupt discontinuation. This study examined the
effects of in-hospital statin discontinuation on patient outcomes in
elderly traumatic brain injury (TBI) patients.
Methods:
This was a multicenter, retrospective cohort study on consecutively
admitted elderly (≥
55) PIS patients who were diagnosed with a blunt TBI
and who had a hospital length of stay (LOS)
≥ 3 days. Patients who
received an in-hospital statin within 48 hours of admission were
considered continued, and patients who never received an in-hospital
statin were considered discontinued. Differences in in-hospital
mortality, having at least one complication, and LOS
>
1 week were examined between those who continued and
discontinued PIS.
Results:
Of 93
PIS patients, 46 continued and 15 discontinued statin therapy. The
two groups were equivalent vis-a-vis demographic and clinical
characteristics. Those who discontinued statin therapy had a 4-fold
higher mortality rate than those who continued (n
=
4, 27% vs. n
=
3, 7%, P
=
0.055). Statin discontinuation did not have a higher
complication rate, compared to statin continuation (n
=
3, 20% vs. n
=
7, 15%, P
=
0.70), and no difference was seen in the proportion with a hospital
LOS
> 1 week (P >
0.99).
Conclusions:
Though our study is not definitive, it does suggest that the abrupt,
unintended discontinuation of statin therapy is associated with
increased mortality in the elderly TBI population. Continuing
in-hospital statin therapy in PIS users may be an important factor
in the prevention of in-hospital mortality in this elderly TBI
population.
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