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Published on: July 3, 2014
Association between statin use during hospitalisation and mortality in patients with intracerebral haemorrhage: a
Min Yuan1, Xinhua Zhou2, Xiaoqing Lu2
1Department of Neurology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China yuanmin201314@sina.com wxh70949810@126.com.
Insights
Statin use during hospitalization may reduce mortality in patients with intracerebral hemorrhage (ICH). This study found statin users had a significantly lower 90-day mortality risk compared to non-users.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Pharmacology
Background:
- Intracerebral hemorrhage (ICH) is a critical condition with high mortality.
- The role of statin therapy in ICH patient outcomes remains under investigation.
Purpose of the Study:
- To investigate the association between statin use during hospitalization and mortality in patients diagnosed with intracerebral hemorrhage.
- To evaluate the impact of statins on 90-day mortality risk in ICH patients.
Main Methods:
- Retrospective propensity-matched cohort study utilizing the Medical Information Mart for Intensive Care III (MIMIC-III) database.
- Inclusion of 1043 adult patients with ICH admitted between 2001 and 2012.
- Statistical analyses included multivariable Cox regression, propensity score analysis, and inverse probability weighting (IPW) to adjust for confounders and assess 90-day mortality.
Main Results:
- Overall 90-day mortality was 29.8%. Statin users (n=362) had a 23.2% mortality rate, while non-statin users (n=681) had a 33.3% mortality rate.
- Adjusted Cox regression indicated statin use was associated with a 29% reduction in 90-day mortality (HR=0.71, 95% CI 0.52-0.97).
- Inverse probability weighting (IPW) confirmed a significantly lower 90-day mortality in statin users (HR=0.69, 95% CI 0.54-0.88).
Conclusions:
- Statin administration during hospitalization may be linked to decreased risk-adjusted mortality in patients suffering from intracerebral hemorrhage.
- The findings suggest a potential protective effect of statins, warranting further investigation.
- Randomized controlled trials are recommended to definitively establish the efficacy and safety of statins in ICH management.
Objectives:
We examined the relationship between statin use during hospitalisation and mortality in patients with intracerebral haemorrhage (ICH).
Design:
Retrospective propensity-matched cohort study.
Setting:
Patients with ICH (≥18 years old) admitted to Beth Israel Deaconess Medical Center (Boston, Massachusetts, USA) from 2001 to 2012 registered in the Medical Information Mart for Intensive Care III database.
Participants:
1043 patients with ICH (≥18 years) were evaluated for the relationship between statin use during hospitalisation and mortality.
Interventions:
Statin use.
Primary And Secondary Outcome Measures:
The primary outcome was 90-day mortality. We used multivariable Cox regression analyses to calculate the adjusted HR with 95% CI and used propensity score analysis and an inverse probability weighting (IPW) model to ensure the robustness of our findings.
Results:
We included 1043 patients with ICH (362 and 681 were statins and non-statin users, respectively) between 2001 and 2012. The overall 90-day mortality was 29.8% (311/1043); it was 33.3% (227/681) and 23.2% (84/362) for non-statin and statin users, respectively. After adjusted for potential confounders, we found that statin use was associated with 29% lower of 90-day mortality (HR=0.71, 95% CI 0.52 to 0.97, p<0.05). IPW also demonstrated a significantly lower 90-day mortality in statin users. The HR was 0.69 (95% CI 0.54 to 0.88, p<0.01). The results remain stable in subgroup analyses and propensity score matching.
Conclusion:
Statin use during hospitalisation may be associated with reduced risk-adjusted mortality in patients with ICH. Further randomised controlled trials are needed to clarify this association.
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