Abstract
INTRODUCTION: Statins are frequently prescribed to lower the risk of atherosclerosis and cardiovascular-related diseases. While statins are considered safe, there are occasional accidental overdoses in children that warrant concern for how to protect children from unintended consumption. We aimed to determine which statins were more prone to injury, characterize the injury types commonly seen for each statin, assess the age at which statin-related injuries were most frequent, and compare statin-related injuries among genders. METHODS: We accessed the National Electronic Injury Surveillance System (NEISS) database to collect hospital cases of drug-related injuries among children that occurred between 2013-2022. Out of these cases, subjects for this study were selected based on the inclusion criteria of statin-related injury. Additionally, we used disposition codes to identify the outcomes for each statin and children under three years of age. Descriptive statistics were utilized to display the frequency of disposition codes corresponding to specific statins and statin-related injuries by age. A regression analysis was then conducted to create a trend line showing the incidence of statin-related injury among males. RESULTS: From 2013 to 2022, there were 81 statin-related injuries. Across the different statins, atorvastatin had the highest incidence of injuries among children under three years old (n=51), with a hospitalization rate of 39.22%. However, atorvastatin had the lowest hospitalization rate compared to other medications, such as rosuvastatin (67.0%) and simvastatin (47.0%). Hospitalization criteria were based on the disposition code 4: treated and admitted to the hospital. When comparing statin-related injuries in terms of age, we specifically found that atorvastatin-related consumption increased exponentially from nine months (n=1) to its highest occurrence at 24 months (n=16) with a percent change of 15%. The elevated occurrence at 24 months suggests that some developmental milestones in infants may make children more susceptible to atorvastatin-related injury. Additionally, a notable absence of statin-related injuries was identified after 24 months, followed by a recurrence at 36 months of age (n=8). When comparing statin-related injuries in terms of female and male children under three years, a notable finding was the continuous increase in male injuries from 2013-2021. The increase is significant in 2021, where there were a total of nine cases; two were female, and seven were male. The data showed a greater number of male cases (55.8%). The data also showed a rise in male visits to the emergency department between 2018 and 2021, possibly due to COVID-19. To explain, more children were at home with their parents/caretakers, which could have been the reason for the increase in accidental ingestion of statins. CONCLUSIONS: Producing statins in colors appealing to children can increase the incidence of accidental consumption. This risk peaks till the age of two years, coinciding with the completion of the oral fixation developmental milestone. To address this issue, Electronic Health Records (EHR) prompts can assist physicians in taking a more proactive approach to prescription safety during their discussions with patients to create a safer environment for children.