Hyperlipidemia and Statins Affect Neurological Outcome in Lumbar Spine Injury

Wu-Fu Chung, Shih-Wei Liu, Peng-Yuan Chang, Feng-Shu Lin, Li-Fu Chen, Jau-Ching Wu, Yu-Chun Chen, Laura Liu, Wen-Cheng Huang, Henrich Cheng and Su-Shun Lo
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Wu-Fu Chung: Department of Emergency Medicine, National Yang-Ming University Hospital, I-Lan 260, Taiwan
Shih-Wei Liu: Department of Emergency Medicine, National Yang-Ming University Hospital, I-Lan 260, Taiwan
Peng-Yuan Chang: Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei 112, Taiwan
Feng-Shu Lin: Department of Pharmacy, National Yang-Ming University Hospital, I-Lan 260, Taiwan
Li-Fu Chen: Department of Emergency Medicine, National Yang-Ming University Hospital, I-Lan 260, Taiwan
Jau-Ching Wu: Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei 112, Taiwan
Yu-Chun Chen: School of Medicine, National Yang-Ming University, Taipei 112, Taiwan
Laura Liu: Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
Wen-Cheng Huang: Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei 112, Taiwan
Henrich Cheng: Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei 112, Taiwan
Su-Shun Lo: School of Medicine, National Yang-Ming University, Taipei 112, Taiwan

IJERPH, 2015, vol. 12, issue 1, 1-12

Abstract: The disabling pathophysiologic effects of lipid and neuroprotective effects of statins have recently been demonstrated for acute spinal cord injuries in animal models. This large scale population-based study aimed to investigate the effect hyperlipidemia and the use of statins in patients with lumbar spine injury. The National Health Insurance Research Database of Taiwan was used to identify patients with lumbar spine injury. A total of 2844 patients were grouped into three: no hyperlipidemia, hyperlipidemia using low-dose of statins (?90 of the defined daily dosage (DDD)), and severe hyperlipidemia using high-dose of statins (>90 DDD). A Cox multiple regression model was used to compare the incidence rates of disability among the three groups. The results showed that patients with hyperlipidemia appeared a higher risk of permanent disability (adjusted HR = 1.38, p = 0.28). In subgroup analysis, patients with severe hyperlipidemia had a higher risk of disability (adjusted HR = 3.1, p < 0.004), whereas hyperlipidemia using low-dose statins had a similar risk of permanently disability (adjusted HR = 0.83, p = 0.661). Hyperlipidemia adversely affected the neurological outcomes of lumbar spinal injury. Statins may have the potential to reverse this higher risk of disability. However, this beneficiary effect of statins only existed in patients using a lower dose (?90 DDD).

Keywords: statins; hyperlipidemia; lumbar spine injury; national health insurance (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2015
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