title: Association between statin use at admission to inpatient rehabilitation and functional status at discharge among older patients.
abstract: The effect of statins on functional status in older patients is unclear. Statins might carry a deleterious effect on muscle function leading to myopathy and therefore affecting functional recovery. We evaluated the relationship between statin exposure at in-hospital rehabilitation admission and functional outcome at discharge. This was a retrospective cohort study of older patients 70 years and older consecutively admitted to an in-hospital rehabilitation after an acute hospitalization. Statin exposure was measured at the time of rehabilitation admission. Functional status was defined with the Barthel Index (BI) score at the time of discharge. A multi-variable linear regression model was used to evaluate the association between statin exposure and functional status at discharge adjusting for potential confounders through a propensity score for statin exposure. A total of 2435 patients were included. The cohort had a mean age of 81.1 years. Of these 9% (n=220) were on statins at the time of admission. In the multi-variable analysis, the use of statins at the time of admission was independently associated with an improved functional status at discharge (point estimate 5.2; 95% confidence interval 1.5-8.9; p<0.01) after adjusting for relevant confounders. Patients who were receiving statins at the time of admission had a BI score 5 points higher compared to those who were not receiving statins. The use of statins was overall safe in a group of co-morbid older patients undergoing rehabilitation training after an acute hospitalization. Additionally, a possible benefit was found given the positive association between statin use and higher functional status at discharge.
authors.affiliation: 1 Department of Rehabilitation and Aged Care, Ancelle Hospital , Cremona, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Morandi
authors.forename: Timothy D
authors.initials: TD
authors.lastname: Girard
authors.forename: Ayumi
authors.initials: A
authors.lastname: Shintani
authors.forename: Renato
authors.initials: R
authors.lastname: Turco
authors.forename: Fabio
authors.initials: F
authors.lastname: Guerini
authors.forename: Tiziana
authors.initials: T
authors.lastname: Torpilliesi
authors.forename: Simona
authors.initials: S
authors.lastname: Gentile
authors.forename: Marco
authors.initials: M
authors.lastname: Trabucchi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Bellelli
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D006760:Hospitalization; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007297:Inpatients; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D009132:Muscles / Q000187:drug effects*; D010343:Patient Admission; D010351:Patient Discharge; D020127:Recovery of Function / Q000502:physiology; D012046:Rehabilitation / Q000379:methods; D012189:Retrospective Studies
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors