Effects of Statins for Secondary Prevention on Functioning and Other Outcomes Among Nursing Home Residents.
Andrew R Zullo, Richard Ofori-Asenso, Marci Wood and 6 others
PMID 32144051WHAT IT FOUND
Starting statins after AMI in frail nursing home residents was associated with an average 16-day increase in survival time over one year.
It was not associated with differences in functional decline or rehospitalization.
Key findings
01Statin use after AMI was associated with lower one-year mortality, with an average 16-day increase in survival time.
02Statin use was not associated with functional decline.
03Statin use was not associated with all-cause rehospitalization.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for RNs
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What it does not show
The study was observational, so unmeasured factors could explain the mortality association. An unmeasured confounder associated with both statin use and mortality at a risk ratio of 1.61 could explain the observed mortality effect. Residents who died or were rehospitalized within 14 days of discharge were excluded, so the results apply only from day 14 after discharge. Functional decline was measured at MDS assessments rather than continuously, so declines between assessments could be missed. Statin dose could not be analysed, so high-dose effects on muscle symptoms and function remain uncertain. The authors note that hazard ratios may exaggerate treatment effects, so they also reported time-based outcomes.
Declared interests
The article lists NIH and U.S. government research support. The conflict-of-interest statement says all other authors have no relevant conflicts of interest to report.
The easy way to misread this
Do not conclude that statins caused the 16-day survival difference or are functionally safe for all nursing home residents. The study was observational, residual confounding cannot be ruled out, and functional decline was measured only intermittently on MDS assessments.