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Inflammation appears to play a central role. Some evidence proposes that statins (HMG-CoA reductase inhibitors) may modulate this inflammation via their pleiotropic properties (non-cholesterol lowering effects). These include suppression of complement activation, vasodilation and inhibition of platelet function and aggregation. The purpose of this systematic review and meta-analysis was to investigate whether pre-morbid statin use is associated with differences in outcomes after trauma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>MEDLINE, EMBASE, Central, Google Scholar, clinicaltrials.gov, clinicaltrialsregister.eu and the German clinical trials register were searched for articles published between 01.09.1987 and 31.12.2023 examining pre-morbid statin use on outcomes after trauma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After removal of duplicates, 623 records for abstract review were identified, of which nine were included in the systematic review and eight the meta-analysis. All studies were retrospective and most did not confirm in-hospital administration of pre-morbid statins. All had a high risk of bias. Grading of Recommendations Assessment indicated a very low certainty of results. When considering pre-morbid statin use in all types of trauma, the overall mortality risk ratio was 0.66 (95% CI 0.37\u20131.17) with high heterogeneity (I2\u2009=\u200999%). The use of statins before traumatic brain injury (TBI) indicated a mortality risk ratio of 0.60 (95% CI 0.28\u20131.27, I2\u2009=\u200996%). Analysis non-TBI studies yielded a risk ratio of 0.84 [95% CI 0.56\u20131.27].<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In a limited meta-analysis, data failed to demonstrate an association between pre-morbid statin use following serious injury. As this may be due to a heterogeneity in data, variable study population, and a number of confounding factors, further dedicated study is warranted to clarify whether observed associations reflect pharmacologic effects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00423-026-04011-8","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T09:55:15Z","timestamp":1775123715000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pre-morbid statin use and mortality in trauma: a systematic review and meta-analysis"],"prefix":"10.1007","volume":"411","author":[{"given":"Andrew","family":"Markle","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravi","family":"Vissapragada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaethe","family":"Sabr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zane B.","family":"Perkins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry D.","family":"De\u2019Ath","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,2]]},"reference":[{"key":"4011_CR1","unstructured":"British Heart F (2020) Statins: 10 facts you might not know. 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