Statin use and fall-related hospitalizations among residents of long-term care facilities: A case-control study

Abstract

Statins are associated with muscle-related adverse events, but few studies have investigated the association with fall-related hospitalizations among residents of long-term care facilities (LTCFs). The objective of the study is to investigate whether statin use is associated with fall-related hospitalizations from LTCFs. A case-control study was conducted among residents aged ≥65years admitted to hospital from 2013 to 2015. Cases (n=332) were residents admitted for falls and fall-related injuries. Controls (n=332) were selected from patients admitted for reasons other than cardiovascular and diabetes. Cases and controls were matched 1:1 by age (±2years), index date of admission (±6months), and sex. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated using conditional logistic regression, after considering for history of falls, hypertension, dementia, functional comorbidity index, polypharmacy (≥9 regular preadmission medications), and fall-risk medications. Subanalyses were performed for individual statins, dementia, and statin intensity. Overall, 43.1% of cases and 27.1% of controls used statins. Statins were associated with fall-related hospitalizations (aOR=2.24, 95% CI 1.56-3.23), in particular simvastatin (aOR=2.26, 95% CI 1.22-4.20) and atorvastatin (aOR=2.08, 95% CI 1.33-3.24). Statins were associated with fall-related hospitalizations in residents with (aOR=2.34, 95% CI 1.33-4.11) and without dementia (aOR=2.30, 95% CI 1.46-3.63). There was no association between statin intensity and fall-related hospitalizations (aOR=0.78, 95% CI 0.43-1.40). This study suggests a possible association between statin use and fall-related hospitalizations among residents living in LTCFs. However, there was minimal evidence for a relationship between statin intensity and fall-related hospitalizations. Further research is required to substantiate these hypothesis-generating findings.