Abstract 60: Inpatient Statin Use in Intracerebral Hemorrhage is Strongly Associated With Improved Survival
Introduction: Inpatient statin use is associated with improved outcomes after ischemic stroke. The impact of inpatient statin use after intracerebral hemorrhage (ICH) is less clear.
Methods: We measured the impact of inpatient and outpatient statin use on 30-day survival among 3,481 patients with a primary discharge diagnosis of ICH over a 10-year period at 19 hospitals in an integrated care delivery system. We used multivariate logistic regression modeling mortality, controlling for patient characteristics, and allowing an interaction between inpatient and outpatient statin use. We also used last prior treatment analysis (LPTA), an instrumental variable reflecting local geographic and temporal treatment environment, to control for potential confounding in probit models.
Results: Kaplan-Meier analysis showed significant differences in survival after ICH among statin users before and during hospitalization (n=769), statin non-users before and during hospitalization (n=1,896), and patients who underwent statin withdrawal (n=391) (see Figure). Controlling for patient characteristics including initial severity, inpatient statin use was associated with lower mortality after ICH (odds ratio [OR] = 0.40, 95% C.I. 0.25 - 63, P<0.001) and withdrawal from statins was associated with higher mortality (OR = 2.30, 95% C.I. 1.40 - 3.91, P=0.002). LPTA models confirmed the association of inpatient statins with lower mortality (OR = 0.28, 95% C.I. 0.26 - 0.32, P=0.01).
Conclusions: Inpatient statin use is associated with improved survival after ICH, particularly among patients already on a statin as an outpatient at the time of the ICH.
Author Disclosures: A. Flint: None. H. Kamel: None. V. Rao: None. B. Faigeles: None. J. Klingman: None. J. Hemphill: Research Grant; Significant; Cerebrotech. Ownership Interest; Significant; Ornim. Consultant/Advisory Board; Significant; Ornim. S. Johnston: None.
- © 2014 by American Heart Association, Inc.