Medical Service, VA North Texas Health System , Dallas, Texas, USA.
Departments of Internal Medicine and Population and Data Sciences, University of Texas Southwestern , Dallas, Texas, USA.
Brain Inj. 2020 Aug 23;34(10):1367-1374. doi: 10.1080/02699052.2020.1802663. Epub 2020 Aug 13.
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.
To examine the association of statin use with TBI clinical outcomes among patients with TBI.
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.
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).
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.
一些体外和动物研究表明他汀类药物可能对创伤性脑损伤（TBI）的临床结果有有益影响，但临床数据有限。
研究他汀类药物使用与 TBI 患者 TBI 临床结果的相关性。
这是一项回顾性队列研究，研究对象为 Tricare 受益人群，这些人有 TBI 诊断，由杠铃损伤诊断矩阵定义。使用 ICD-9 代码定义结局，包括：脑震荡后综合征、神经障碍、物质依赖或滥用以及精神障碍。使用 103 项基线特征进行倾向评分（PS）匹配他汀类药物使用者和非使用者。
在 1187 名成年 TBI 患者（172 名他汀类药物使用者和 1015 名非使用者）中，我们使用 PS 匹配了 70 名他汀类药物使用者和 70 名非使用者。在 PS 匹配的他汀类药物使用者队列中，与非使用者相比，脑震荡后综合征（比值比 [OR]：0.24，95%置信区间 [CI]：0.03-2.20）、神经障碍（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）的差异无统计学意义。
本研究未显示 TBI 幸存者使用他汀类药物有益或有害。我们的研究结果与一些动物研究和小型随机对照试验的证据不一致。需要进一步研究利用更大的样本量进行研究。
