Preoperative statin therapy is not associated with a decrease in the incidence of delirium after cardiac operations.

Abstract

BACKGROUND:

Delirium after cardiac operations is associated with significant morbidity and death. Statins have been recently suggested to exert protective cerebral effects. This study investigated whether preoperative statins were associated with decreased incidence of postoperative delirium in patients undergoing coronary artery bypass grafting.

METHODS:

The study enrolled 4,659 consecutive patients (21% women; age, 67.8±9.2 years) undergoing coronary artery bypass grafting. A propensity score-based optimal-matching algorithm was used to match 1,577 patients receiving preoperative statins with a control group (1:1). Patients were screened for delirium in the intensive care unit according to the Confusion Assessment Method for the intensive care unit.

RESULTS:

Delirium affected 89 patients (3%), and preoperative statin administration was not multivariably associated with a decreased incidence of delirium (odds ratio, 1.52; 95% confidence interval, 0.97 to 2.37; p=0.18) and was also unrelated to a delirium decrease in patient subgroups undergoing isolated coronary artery bypass grafting (odds ratio, 1.31; 95% confidence interval, 0.68 to 2.52; p=0.51) or combined valvular procedures (odds ratio, 1.72; 95% confidence interval, 0.96 to 3.07, p=0.08). Similar results were observed for age groups and cardiopulmonary bypass durations. Patients affected by postoperative delirium experienced a longer hospital stay (25th to 75th percentile) of 11 (7 to 18 days) vs 7 days (7 to 8 days, p<0.001) and 12% hospital mortality vs 1% (p<0.001).

CONCLUSIONS:

Preoperative statins were not associated with a decreased incidence of delirium in patients undergoing coronary revascularization.

• Authors: Giovanni Mariscalco, Marzia Cottini, Marco Zanobini, Stefano Salis, Carmelo Dominici, Maciej Banach, Francesco Onorati, Gabriele Piffaretti, Giovanna Covaia, Marco Realini, Cesare Beghi
• Journal: The Annals of thoracic surgery (Ann Thorac Surg) Vol. 93 Issue 5 Pg. 1439-47 (May 2012) ISSN: 1552-6259 [Electronic] Netherlands
• PMID: 22541176 (Publication Type: Comparative Study, Journal Article)
• Copyright: Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Chemical References

• Hydroxymethylglutaryl-CoA Reductase Inhibitors

Topics

• Age Factors
• Aged
• Cohort Studies
• Confidence Intervals
• Coronary Angiography (methods)
• Coronary Artery Bypass (adverse effects, methods, mortality)
• Coronary Stenosis (diagnostic imaging, drug therapy, mortality, surgery)
• Delirium (epidemiology, prevention & control)
• Female
• Hospital Mortality (trends)
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors (administration & dosage)
• Incidence
• Length of Stay
• Male
• Middle Aged
• Multivariate Analysis
• Odds Ratio
• Postoperative Complications (epidemiology, prevention & control)
• Preoperative Care (methods)
• Retrospective Studies
• Risk Assessment
• Severity of Illness Index
• Sex Factors