Association between statin use at admission to inpatient rehabilitation and functional status at discharge among older patients.
Association between statin use at admission to inpatient rehabilitation and functional status at discharge among older patients.
复制标题
老年患者住院康复时他汀类药物的使用与出院时功能状态之间的关联。
DOI：
10.1089/rej.2014.1604
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发表时间：
2014
影响因子：
2.6
通讯作者：
Bellelli,Giuseppe
中科院分区：
文献类型：
--
作者：
Morandi,Alessandro;Girard,TimothyD;Shintani,Ayumi;Turco,Renato;Guerini,Fabio;Torpilliesi,Tiziana;Gentile,Simona;Trabucchi,Marco;Bellelli,Giuseppe
他汀类药物对老年患者功能状态的影响尚不清楚。他汀类药物可能对肌肉功能产生有害影响，导致肌病，从而影响功能恢复。我们评估了住院康复治疗时他汀类药物暴露与出院时功能结局之间的关系。这是一项回顾性队列研究，研究对象为70岁及以上急性住院后连续入院接受住院康复治疗的老年患者。在康复入院时测量他汀类药物暴露。出院时用Barthel指数（BI）评分定义功能状态。使用多变量线性回归模型评价他汀类药物暴露与出院时功能状态之间的相关性，通过他汀类药物暴露的倾向评分调整潜在混杂因素。共纳入2435例患者。该队列的平均年龄为81.1岁。其中9%（n=220）在入院时接受他汀类药物治疗。在多变量分析中，调整相关混杂因素后，入院时使用他汀类药物与出院时功能状态改善独立相关（点估计值5.2; 95%置信区间1.5-8.9;p<0.01）。入院时接受他汀类药物治疗的患者的BI评分比未接受他汀类药物治疗的患者高5分。在急性住院后接受康复训练的一组共病老年患者中，使用他汀类药物总体上是安全的。此外，考虑到他汀类药物使用与出院时较高的功能状态之间的正相关性，发现了可能的获益。
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.