Statins in survivors of traumatic brain injury: a propensity score-matched analysis

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.