Statins and minimal/mild Traumatic Brain Injury, over 60 years: a prospective cohort study

Objective : To investigate whether mortality and complication rates after minimal/mild traumatic brain injury (m/mTBI) differ between elderly patients who are chronically treated with statins and those who are not. Design : Prospective cohort study. Methods Over-60-year-olds (n=5067) admitted to our Emergency Department within 24 hours of m/mTBI between 29 October 2010 and 5 May 2013 and between 17 November 2017 and 30 June 2020, and patients referred for brain CT scan from other centres who met study eligibility criteria. Study inclusion criteria were age >60 years; m/mTBI <24 h before admission and GCS score of 14 or 15 with or without transient loss of consciousness or amnesia. Quantitative variables were expressed as medians with interquartile range (IQR) and categorical variables as frequencies and percentages. In bivariate analyses, haemorrhagic complication and mortality rates were compared between statin and non-statin groups and a predictive multivariate logistic regression model was constructed for mortality. Results: The mean age was 80 years and 2982 (58%) were female. A significantly higher percentage of the statin group had GCS score of 15 (p<0.032), injury mechanism other than fall (p<0.003), craniofacial injury (p<0.004), comorbidity (p<0.001) (kidney failure, hypertension, liver disease, neurological disease, and diabetes), and chronic intake of benzodiazepines (0.002), antiplatelets (<0.001), direct anticoagulants (p<0.001), and haemorrhagic complication (0.023),. No between-group difference was observed in haemorrhagic progression (0.066), hospitalization (0.716) or mortality (0.625) rates. Conclusions: Chronic statin consumption did not protect patients over 60 years of age from the negative cerebral effects of m/mTBI..