American journal of surgery · 2025
Pre-injury statin therapy is associated with lower VTE after traumatic brain injury.
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Sanders Kelly E, Hatton Gabrielle E, Karpe Ashna S, Luciano Mabel P, Bavishi Devi A, Burczak Keith W, Van Gent Jan Michael, Mokhtari Ava, Cotton Bryan A, McNutt Michelle K, Puzio Thaddeus J
Аннотация
BACKGROUND: Hemorrhage progression is a potentially devastating complication after TBI, mandating delay to VTE prophylaxis in high-risk patients. Statins have endothelial stabilizing effects associated with decreased VTE in other populations.
OBJECTIVE: To explore whether prehospital statin exposure is associated with decreased incidence of VTE in TBI.
METHODS: This retrospective cohort study included adult trauma patients and excluded bleeding disorder, disseminated cancer, pregnancy, and deaths <24 h. TBI progression, VTE incidence, VTE prophylaxis type/timing were assessed, grouped by prehospital statin exposure. Univariate and multivariable analyses were performed.
RESULTS: 148/1188 patients used statins. Statin users were older (71.5 vs 41 years, p < 0.001) with lower injury severity score (22 vs 27, p < 0.001) and higher incidence of pre-existing comorbidities. Time to DVT prophylaxis was shorter (35.2 vs 38.8 h, p = 0.005) and plasma transfusion within 4 h of admission was lower for statin users (0 vs 1 unit, p = 0.039). Statin use was associated with less progression of TBI (24.3 % vs 37 %, Fisher's exact test p < 0.001) and lower incidence of DVT (1.4 % vs 2.2 %, p < 0.001. After controlling for known covariates, statin users had a lower odds of developing VTE (OR = 0.24, 95 % CI 0.06-0.99; p = 0.048).
CONCLUSIONS: Statin exposure was associated with decreased incidence of VTE after TBI.
OBJECTIVE: To explore whether prehospital statin exposure is associated with decreased incidence of VTE in TBI.
METHODS: This retrospective cohort study included adult trauma patients and excluded bleeding disorder, disseminated cancer, pregnancy, and deaths <24 h. TBI progression, VTE incidence, VTE prophylaxis type/timing were assessed, grouped by prehospital statin exposure. Univariate and multivariable analyses were performed.
RESULTS: 148/1188 patients used statins. Statin users were older (71.5 vs 41 years, p < 0.001) with lower injury severity score (22 vs 27, p < 0.001) and higher incidence of pre-existing comorbidities. Time to DVT prophylaxis was shorter (35.2 vs 38.8 h, p = 0.005) and plasma transfusion within 4 h of admission was lower for statin users (0 vs 1 unit, p = 0.039). Statin use was associated with less progression of TBI (24.3 % vs 37 %, Fisher's exact test p < 0.001) and lower incidence of DVT (1.4 % vs 2.2 %, p < 0.001. After controlling for known covariates, statin users had a lower odds of developing VTE (OR = 0.24, 95 % CI 0.06-0.99; p = 0.048).
CONCLUSIONS: Statin exposure was associated with decreased incidence of VTE after TBI.