Table 1 Observational studies
From: Clinical review: Statins and trauma - a systematic review
| Study | Design | Participants | Exposure | Comparisons | Outcome | Results | Subgroup analyses | Remarks |
|---|---|---|---|---|---|---|---|---|
| Fogerty et al. (2010) [32] | Retrospective cohort study | 223 patients, aged ≥55 years, with thermal burns, admitted to a regional burns centre | Pre-injury statin use (n = 70), duration not specified, continued after hospitalisation in 77% | No pre-injury statin use (n = 153) |
In-hospital mortality Infection Septic shock |
OR 0.17 (95% CI 0.05-0.57) OR 0.90 (95% CI 0.48-1.7) OR 0.50 (95% CI 0.20-1.30) | No change in odds ratio when stratified by cardiovascular comorbidities |
Statin therapy continued after hospitalisation in 77% Multivariate regression analysis determined odds ratios of death and sepsis by statin use, adjusting for cardiovascular comorbidities |
| Efron et al. (2008) [28] | Retrospective cohort study | 1,224 patients, aged 65-84 years with moderate-severe traumatic injury (AIS ≥3), survival >24 h, participating in NSCOT study | Pre-injury statin use (21.1%), duration not specified, continuation after admission not known | No pre-injury statin use (78.9%) | In-hospital mortality | OR 0.33 (95% CI 0.12-0.92) |
Subgroup with cardiovascular comorbidity (n = 414): OR 1.41 (95% CI 0.72-2.72) Subgroup without cardiovascular comorbidity (n = 775): OR 0.30 (95% CI 0.10-0.91) |
Multivariate logistic regression analysis NSCOT study captured pre-injury medication by class only. No data on compliance, duration, dose, or whether continued after admission to hospital NSCOT study used very complex statistical sampling model |
| Neal et al. (2009) [29] | Retrospective cohort study | 295 patients, aged 55-90 years, blunt mechanism of injury, hypotension (systolic blood pressure <90 mmHg) or biochemical evidence of hypoperfusion (base deficit >5 meq/L) on admission, blood transfusion requirement, at least one AIS ≥2 other than head, survival >24 h, participating in Host Response to Injury Large Scale Collaborative Program | Pre-injury statin use (n = 71), as verified by patient or relative | No pre-injury statin use (n = 224) |
In-hospital mortality Nosocomial infection (microbiologically confirmed pneumonia, catheter-related bloodstream infection or urinary tract infection) Multi-organ failure (defined as Marshall score >5) |
HR 1.98 (95% CI 0.9-4.0) HR 0.78 (95% CI 0.5-1.4) HR 1.81 (95% CI 1.1-2.9) |
Propensity score adjusted regression analysis to control for differences in baseline characteristics No data on whether statin therapy was continued after hospital admission | |
| Schneider et al. (2011) [30] | Retrospective cohort study | 523 patients, aged 65 years and older, with head AIS ≥3, survival >24 h, participating in NSCOT study | Pre-injury statin use (22.3%), duration not specified, continuation after admission not known | No pre-injury statin use (77.7%) |
In-hospital mortality Extended Glasgow Outcome Scale insurvivors at 3 and 12 months after injury |
RR 0.24 (95% Cl 0.08-0.69) RR at 3 months 0.77 (95% Cl 0.42-1.41) RR at 12 months 1.13 (95% Cl 1.01-1.26) |
Mortality subgroup with cardiovascular comorbidity: RR 0.87 (95% Cl 0.50-1.50) Subgroup without cardiovascular comorbidity: RR 0.17 (95% Cl 0.05-0.63) | Multivariate logistic regression analysis. NSCOT study captured pre-injury medication by class only. No data on compliance, duration, dose, or whether continued after admission to hospital. NSCOT study used very complex statistical sampling model |