J Trauma Acute Care Surg. 2026 Aug 3. doi: 10.1097/TA.0000000000005148. Online ahead of print.
ABSTRACT
BACKGROUND: The risk of venous thromboembolism (VTE) in subsets of the most severely injured patients can approach 30%. Statins have anti-inflammatory properties and exert beneficial effects on the endothelium, but few previous studies have evaluated their effects on VTE in risk-stratified groups. We hypothesized that statin use was associated with lower VTE in high-risk trauma patients.
METHODS: All patients admitted to the trauma intensive care unit (ICU) from 1/2024 to 11/2024 at a single level 1 trauma center were risk-stratified using the Greenfield Risk Assessment Profile (RAP). Nontrauma patients and burn patients were excluded. Outcomes were compared between patients with and without VTE, defined by deep vein thrombosis or pulmonary embolism. Univariate analyses and multivariate logistic regression evaluated the association between statin use and VTE. Statistical significance was assessed at p≤0.05.
RESULTS: In 509 patients (age 52±22 y, 71% male, 18% penetrating injury), the average RAP score was 10±5, the overall VTE rate was 17%, and mortality was 5%. Compared with statin nonusers, statin users (n=100) were older, with more blunt injury, similar RAP scores and thromboprophylaxis use, but had a significantly lower VTE rate (8 vs. 19%, P=0.007). After RAP-based stratification, the high-risk group (RAP≥10) had a VTE rate of 28%. After controlling for confounding variables with multivariate logistic regression, statin use was independently associated with decreased VTE with an odds ratio of 0.209 (95% CI: 0.065-0.670, P=0.008).
CONCLUSIONS: Severely injured patients have high rates of VTE despite thromboprophylaxis;, however, the incidence of VTE was significantly lower among statin users. In the highest risk patients, statin use was independently associated with decreased odds of VTE. Because of their pleiotropic effects, including anti-inflammatory and endothelial protective properties, statins may be an important adjunctive therapy in VTE chemoprophylaxis. (J Trauma Acute Care Surg. 2026;00: 000-000 Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved.).
LEVEL OF EVIDENCE: Level III, therapeutic/care management.
PMID:42545722 | DOI:10.1097/TA.0000000000005148
