Statins in survivors of traumatic brain injury: a propensity score-matched analysis

ABSTRACT

Background

Several in-vitro and animal studies suggest that statins may have beneficial effects on clinical outcomes of traumatic brain injury (TBI), however, clinical data are scarce.

Objectives

To examine the association of statin use with TBI clinical outcomes among patients with TBI.

Methods

A retrospective cohort study of Tricare beneficiaries who had a TBI diagnosis, as defined by the Barbell injury diagnosis matrix. Outcomes were defined using ICD-9 codes and included: post-concussion syndrome, neurological disorders, substance dependence or abuse, and psychiatric disorders. Statin-users and non-users were propensity score (PS)-matched using 103 baseline characteristics.

Results

Out of 1187 adult patients with a TBI diagnosis (172 statin-users and 1015 nonusers), we PS-matched 70 statin-users to 70 non-users. There were no statistically significant differences in the PS-matched cohort of statin-users in comparison to nonusers for post-concussion syndrome (odds ratio [OR]: 0.24, 95% confidence interval [CI]: 0.03–2.20), neurological disorders (OR: 0.60, CI: 0.31–1.16); substance dependence or abuse (OR: 0.80, CI: 0.40–1.60), or psychiatric disorders (OR 0.80, CI: 0.41–1.55).

Conclusion

This study did not show benefit or harm for statins among survivors of TBI. Our findings do not support the evidence from some animal studies and small randomized controlled trials. Further studies utilizing larger sample sizes are warranted.

KEYWORDS:

• Statins
• traumatic brain injury
• post-concussion syndrome
• neurological disorders
• substance dependence or abuse
• psychiatric disorders

Disclaimer

The views expressed herein are those of the authors and do not reflect the official policy or position of the Department of the Army, Department of Defense, Department of Veteran Affairs, or the US Government. The authors are employees of the US government. This work was prepared as part of their official duties and, as such, there is no copyright to be transferred.

Disclosure statement

None

Additional information

Funding

No funding was provided for this work, but this work was supported in part by resources from the North Texas VA Healthcare System, University of Texas Southwestern Medical Center, Dallas, TX, the UT Southwestern Center for Patient-Centered Outcomes Research [AHRQ R24 HS022418] and VA Health Services Research and Development Service [IK6 HX002608-01].