Exposure to Statin Therapy Decreases the Incidence of Venous Thromboembolism After Trauma

Authors

• Kelly E Sanders
• Gabrielle E Hatton
• Atharwa R Mankame
• Addison C Allen
• Sarah Cunningham
• Jan Michael Van Gent
• Erin E Fox
• Xu Zhang
• Charles E Wade
• Bryan A Cotton
• Jessica C Cardenas

Language

English

Publication Date

11-1-2024

Journal

The Journal of Trauma and Acute Care Surgery

DOI

10.1097/TA.0000000000004319

PMID

38523132

PMCID

PMC11422512

PubMedCentral® Posted Date

11-1-2025

PubMedCentral® Full Text Version

Author MSS

Abstract

Introduction: Venous thromboembolism (VTE) is a leading cause of morbidity and mortality in trauma patients, despite chemoprophylaxis. Statins have been shown capable of acting upon the endothelium. We hypothesized that statin therapy in the pre- or in-hospital settings leads to a decreased incidence of VTE.

Methods: We conducted a retrospective cohort study of injured patients who received statin therapy pre- or in-hospital. Adult, highest-level trauma activation patients admitted from January 2018 to June 2022 were included. Patients on prehospital anticoagulants, had history of inherited bleeding disorder, and who died within the first 24 hours were excluded. Statin users were matched to nonusers by statin use indications including age, current heart and cardiovascular conditions and history, hyperlipidemia, injury severity, and body mass index. Time to in-hospital statin initiation and occurrence of VTE and other complications within 60 days were collected. Differences between groups were determined by univariate, multivariable logistic regression, and Cox proportional hazard analyses.

Results: Of 3,062 eligible patients, 79 were statin users, who were matched to 79 nonusers. There were no differences in admission demographics, vital signs, injury pattern, transfusion volumes, lengths of stay, or mortality between groups. The overall VTE incidence was 10.8% (17 of 158). Incidence of VTE in statin users was significantly lower (3%) than nonusers (19%; p = 0.003). Differences between statin users and nonusers were observed for rates of deep vein thrombosis (0% vs. 9%), pulmonary embolism (3% vs. 15%), and sepsis (0% vs. 5%). Exposure to statins was associated with an 82% decreased risk of developing VTE (hazard ratio, 0.18; 95% confidence interval, 0.04-0.86; p = 0.033).

Conclusion: Statin exposure was associated with decline in VTE and lower individual rates of deep vein thrombosis, pulmonary embolism, and sepsis. Our findings indicate that statins should be evaluated further as a possible adjunctive therapy for VTE chemoprophylaxis after traumatic injury.

Level of evidence: Therapeutic/Care Management; Level IV.

Keywords

Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Venous Thromboembolism, Female, Male, Retrospective Studies, Incidence, Middle Aged, Wounds and Injuries, Aged, Adult, cardiovascular, chemoprophylaxis, statin, trauma, venous thromboembolism

Published Open-Access

yes

Recommended Citation

Sanders, Kelly E; Hatton, Gabrielle E; Mankame, Atharwa R; et al., "Exposure to Statin Therapy Decreases the Incidence of Venous Thromboembolism After Trauma" (2024). Faculty, Staff and Student Publications. 3707.
https://digitalcommons.library.tmc.edu/uthmed_docs/3707