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

Background: 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). Objective: The objective of the study is to investigate whether statin use is associated with fall-related hospitalizations from LTCFs. Methods: A case-control study was conducted among residents aged ≥65 years 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 (±2 years), index date of admission (±6 months), 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. Results: 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). Conclusion: 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.