Lower In-Hospital Mortality Linked to In-Hospital Statin Exposure

The in-hospital mortality of older adults was significantly lower in those who used in-hospital statins, even after adjustment for health status at admission and before their visit to the hospital. The study, published in Acta Clinica Belgica,¹ encourages future research into short-term effects of statins.

Statins are a method of preventing cardiovascular disease, as they can lead to lower risks of myocardial infarction, stroke, and mortality related to cardiovascular problems.² Past studies have found that older adults had similar results in those aged 75 years or older compared with younger adults.³ This study aimed to assess if statin exposure was associated with in-hospital mortality in older adults admitted to the acute geriatric ward.¹

The study was retrospective, and all data from December 9, 2022, through July 24, 2023, were collected for the study. Participants were aged 75 years and older who were admitted to the acute geriatric unit during this timeframe. Any patient who died within 24 hours of admission was excluded. Statin therapy during hospitalization acted as the exposure of interest, and the primary outcome was in-hospital mortality.

Actual administration of a statin to the patient on the second day of hospital admission was considered as being exposed to statin therapy. The primary independent variable was statin use during hospitalization, with age, sex, comorbidity burden, and functional status all acting as covariates.

There were 545 patients included in the study, where 23.5% received statin therapy. The mean (SD) age of the patients was 85.9 (5.5) years, and those in the statin group were slightly younger compared with the non-statin group. A total of 60.6% of the participants were women, and functional status was similar between the 2 groups. Statin users had slightly higher comorbidity burden, as measured by the Charlson Comorbidity Index (7.1 [2.1] vs 6.5 [2.1]). Statin users were more likely to have a history of myocardial infarction and diabetes.

A total of 13.4% of the participants died during hospitalization, where 8.6% of statin users and 14.9% of nonusers experienced in-hospital mortality. The unadjusted absolute risk difference was –6.3%. Statin use was associated with lower odds of in-hospital mortality (adjusted OR, 0.50; 95% CI, 0.3-1.0). This relationship remained after adjustment for a history of systemic inflammation or atherosclerotic cardiovascular disease. When stratifying by ASCVD status, patients treated for secondary and primary prevention had comparable associations (adjusted OR, 0.5 and 0.6, respectively).

There were some limitations to this study. Causal inference could not be drawn due to the observational design of the study. All data on statin use before the hospital admission were not available. Statistical power was reduced due to the smaller sample size. Residual and unmeasured confounders are possible despite adjustment. Changes in therapy were not accounted for, and any changes in statin therapy could have biased effect estimates.

“These findings support a potential role for statin continuation or initiation during acute illness in geriatric patients,” the authors concluded. “To advance clinical decision-making within this framework, future trials are needed to investigate the short-term effects of statins in older adults with and without established cardiovascular disease…”

References

1. Monsieur L, Schets I, Rössler R, et al. Real-world evidence on in-hospital statin use and mortality in geriatric patients. Acta Clin Belg. Published online June 9, 2026. doi:10.1080/17843286.2026.2684717
2. Statins. Cleveland Clinic. Updated March 12, 2024. Accessed June 9, 2026. https://my.clevelandclinic.org/health/treatments/22282-statins
3. Nanna MG, Navar AM, Wang TY, et al. Statin use and adverse effects among adults >75 years of age: insights from the Patient and Provider Assessment of Lipid Management (PALM) registry. J Am Heart Assoc. 2018;7(10):e008546. doi:10.1161/JAHA.118.008546