Association between statin use during hospitalisation and mortality in patients with intracerebral haemorrhage: a propensity score-matched cohort study

BMJ Open. 2022 Dec 30;12(12):e065849. doi: 10.1136/bmjopen-2022-065849.

Abstract

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.

Keywords: pharmacology; public health; stroke; stroke medicine.

MeSH terms

  • Adolescent
  • Cerebral Hemorrhage / drug therapy
  • Cohort Studies
  • Hospitalization
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors* / therapeutic use
  • Propensity Score
  • Retrospective Studies

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors