Statin use and fall-related hospitalizations among residents of long-term care facilities: A case-control study

Kate N Wang; J Simon Bell; Edwin Ck Tan; Julia Fm Gilmartin-Thomas; Michael J Dooley; Jenni Ilomäki

doi:10.1016/j.jacl.2020.05.008

Statin use and fall-related hospitalizations among residents of long-term care facilities: A case-control study

J Clin Lipidol. 2020 Jul-Aug;14(4):507-514. doi: 10.1016/j.jacl.2020.05.008. Epub 2020 May 22.

Authors

Kate N Wang¹, J Simon Bell², Edwin Ck Tan³, Julia Fm Gilmartin-Thomas⁴, Michael J Dooley⁵, Jenni Ilomäki⁶

Affiliations

¹ Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia; Pharmacy Department, Alfred Health, Melbourne, Victoria, Australia; School of Health & Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia. Electronic address: kate.wang@monash.edu.
² Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia; NHMRC Cognitive Decline Partnership Centre, Hornsby Ku-ring-gai Hospital, Hornsby, New South Wales, Australia; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia.
³ Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia; Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; The University of Sydney, Faculty of Medicine and Health, School of Pharmacy, Sydney, New South Wales, Australia.
⁴ Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
⁵ Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia; Pharmacy Department, Alfred Health, Melbourne, Victoria, Australia; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
⁶ Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.

PMID: 32571729
DOI: 10.1016/j.jacl.2020.05.008

Abstract

Background: Statins are associated with muscle-related adverse events, but few studies have investigated the association with fall-related hospitalizations among residents of long-term care facilities (LTCFs).

Objective: The objective of the study is to investigate whether statin use is associated with fall-related hospitalizations from LTCFs.

Methods: A case-control study was conducted among residents aged ≥65 years admitted to hospital from 2013 to 2015. Cases (n = 332) were residents admitted for falls and fall-related injuries. Controls (n = 332) were selected from patients admitted for reasons other than cardiovascular and diabetes. Cases and controls were matched 1:1 by age (±2 years), index date of admission (±6 months), and sex. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated using conditional logistic regression, after considering for history of falls, hypertension, dementia, functional comorbidity index, polypharmacy (≥9 regular preadmission medications), and fall-risk medications. Subanalyses were performed for individual statins, dementia, and statin intensity.

Results: Overall, 43.1% of cases and 27.1% of controls used statins. Statins were associated with fall-related hospitalizations (aOR = 2.24, 95% CI 1.56-3.23), in particular simvastatin (aOR = 2.26, 95% CI 1.22-4.20) and atorvastatin (aOR = 2.08, 95% CI 1.33-3.24). Statins were associated with fall-related hospitalizations in residents with (aOR = 2.34, 95% CI 1.33-4.11) and without dementia (aOR = 2.30, 95% CI 1.46-3.63). There was no association between statin intensity and fall-related hospitalizations (aOR = 0.78, 95% CI 0.43-1.40).

Conclusion: This study suggests a possible association between statin use and fall-related hospitalizations among residents living in LTCFs. However, there was minimal evidence for a relationship between statin intensity and fall-related hospitalizations. Further research is required to substantiate these hypothesis-generating findings.

Keywords: Falls; Hospitalization; Long-term care; Nursing homes; Statins.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Accidental Falls / statistics & numerical data*
Aged
Aged, 80 and over
Case-Control Studies
Female
Hospitalization / statistics & numerical data*
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors / adverse effects*
Logistic Models
Long-Term Care / statistics & numerical data*
Male
Middle Aged

Substances

Hydroxymethylglutaryl-CoA Reductase Inhibitors