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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
  1. AIS, Abbreviated Injury Scale; CI, confidence interval; HR, hazard ratio; NSCOT, National Study on the Costs and Outcomes of Trauma; OR, odds ratio.