.jpg "Michelle Kitsis photo")
.jpg "Amy Stewart, MD, FACS photo")
Amy Stewart, MD, FACS
Trauma Surgeon
Advocate Lutheran General Hospital
Park Ridge, Illinois, United States
Disclosure information not submitted.
Kenneth Schaffer, MSN, APRN, AGACNP-BC, RVT
APN
Advocate Lutheran General Hospital, United States
Disclosure information not submitted.
Jenna Sutton, BS
Medical Student
Chicago Medical School, United States
Disclosure information not submitted.
Maureen Shields, MPH
PCOR Coordinator
Russell Center for Research & Innovation, United States
Disclosure information not submitted.
John White, MD
Chairman of Surgery
Advocate Lutheran General Hospital, United States
Disclosure information not submitted.
Title: Effect of Statin use on Incidence of VTE in the Adult Trauma Population
Introduction: The incidence of venous thromboembolism (VTE) in the setting of trauma ranges widely from 6-58% dependent on patient specific risk factors and remains a major cause of morbidity and mortality. Of the estimated 900,000 people in the US affected by VTE each year, approximately 300,000 result in death. Trauma-related VTE is associated with higher incidence of sepsis, organ failure, longer hospital stay and mortality. There has been emerging evidence that statins may help reduce the incidence of VTE due to their anti-inflammatory properties, although the literature remains inconclusive. This study looks to determine whether the use of statins reduced the incidence of VTE in the trauma population.
Methods: Charts of 101 adult trauma patients with VTE along with 101 matched controls presenting between 7/1/2014 and 9/30/2017 were reviewed. Variables of interest included; VTE status, statin use prior to admission, statin use during inpatient stay, and clinical characteristics.
Results: Pre-admission statin use was associated with increased risk of VTE development (OR 1.99, P-value 0.0441). Patients who received statins during admission also had increased risk of VTE development (OR 1.65), however this finding did not reach statistical significance. Increased risk of VTE was also associated with spinal injury (OR 1.8, p-value 0.03), chest injury (OR 2.095, p-value 0.012), orthopedic injury (OR 2.2, p-value 0.006), orthopedic surgery (OR 1.92, p-value 0.023) and tracheostomy placement (OR 4.42, p-value 0.0005). Both the pre- admission and inpatient statin use group were statistically older than the no statin group. (Age 69.5 vs 51.4 p < 0.0001 and 69.5 vs 53.33 p = 0.001 respectively) No statistically significant difference in incidence of VTE based on co-morbidities.
Conclusions: Incidence of VTE differed between different injury types and was increased in patient with statin use prior to trauma. It is unclear if statin use alone is a risk factor for development of VTE or if any pre-existing condition or mechanism of injury contributed. Age is a risk factor for VTE and the statin group was significantly older which may confound the results. There was no significant difference in co-morbidities between study participants.