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.

中文翻译：

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脑外伤幸存者中的他汀类药物：倾向评分匹配分析。

背景

多项体外和动物研究表明，他汀类药物可能对颅脑外伤（TBI）的临床结局具有有益的作用，但是临床数据很少。

目标

在TBI患者中检查他汀类药物的使用与TBI临床结局的关系。

方法

根据Barbell损伤诊断矩阵定义，对患有TBI诊断的Tricare受益人进行的回顾性队列研究。结果是使用ICD-9代码定义的，包括：脑震荡后综合症，神经系统疾病，药物依赖性或滥用以及精神病。他汀类药物使用者和非使用者的倾向得分（PS）匹配，使用103个基线特征。

结果

在1187名诊断为TBI的成年患者中（172名他汀类药物使用者和1015名非使用者），我们PS匹配了70名他汀类药物使用者和70名非使用者。脑卒中后综合症（非比值[OR]：0.24，95％置信区间[CI]：0.03–2.20），神经系统疾病（非脑震荡综合征）与未使用PS的他汀类药物使用者队列相比，没有统计学上的显着差异。 OR：0.60，CI：0.31-1.16）；物质依赖或滥用（OR：0.80，CI：0.40-1.60）或精神障碍（OR 0.80，CI：0.41-1.55）。

结论

这项研究未显示TBI幸存者对他汀类药物的利弊。我们的发现不支持某些动物研究和小型随机对照试验的证据。有必要使用更大的样本量进行进一步的研究。