Newly Published
Perioperative Medicine  |   February 2017
Lack of Association between Preoperative Statin Use and Respiratory and Neurologic Complications after Cardiac Surgery
Author Notes
  • From the Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California (R.K.); Outcomes Research Consortium, Cleveland, Ohio (R.K., H.O.Y., J.Y., C.A.B., S.R., D.I.S., A.T.); Departments of Quantitative Health Sciences (J.Y.), Cardiothoracic Anesthesiology (C.A.B.), General Anesthesiology (S.R., A.T.), Cardiovascular Surgery (E.G.S.), and Outcomes Research (J.Y., C.A.B., S.R., D.I.S., A.T.), Cleveland Clinic, Cleveland, Ohio; and Department of Anesthesiology and Reanimation, Etimesgut Sait Erturk State Hospital, Ankara, Turkey (H.O.Y.).
  • Submitted for publication June 23, 2016. Accepted for publication January 10, 2017.
    Submitted for publication June 23, 2016. Accepted for publication January 10, 2017.×
  • Research Support: Support was provided solely from institutional and/or departmental sources.
    Research Support: Support was provided solely from institutional and/or departmental sources.×
  • Competing Interests: The authors declare no competing interests.
    Competing Interests: The authors declare no competing interests.×
  • Correspondence: Address correspondence to Dr. Turan: Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, 9500 Euclid Avenue, P-77, Cleveland, Ohio 44195. alparslanturan@yahoo.com. Information on purchasing reprints may be found at www.anesthesiology.org or on the masthead page at the beginning of this issue. Anesthesiology’s articles are made freely accessible to all readers, for personal use only, 6 months from the cover date of the issue.
Article Information
Perioperative Medicine / Cardiovascular Anesthesia / Central and Peripheral Nervous Systems / Respiratory System
Perioperative Medicine   |   February 2017
Lack of Association between Preoperative Statin Use and Respiratory and Neurologic Complications after Cardiac Surgery
Anesthesiology Newly Published on February 23, 2017. doi:10.1097/ALN.0000000000001569
Anesthesiology Newly Published on February 23, 2017. doi:10.1097/ALN.0000000000001569
Abstract

Background: Statins may reduce the risk of pulmonary and neurologic complications after cardiac surgery.

Methods: The authors acquired data for adults who had coronary artery bypass graft, valve surgery, or combined procedures. The authors matched patients who took statins preoperatively to patients who did not. First, the authors assessed the association between preoperative statin use and the primary outcomes of prolonged ventilation (more than 24 h), pneumonia (positive cultures of sputum, transtracheal fluid, bronchial washings, and/or clinical findings consistent with the diagnosis of pneumonia), and in-hospital all-cause mortality, using logistic regressions. Second, the authors analyzed the collapsed composite of neurologic complications using logistic regression. Intensive care unit and hospital length of stay were evaluated with Cox proportional hazard models.

Results: Among 14,129 eligible patients, 6,642 patients were successfully matched. There was no significant association between preoperative statin use and prolonged ventilation (statin: 408/3,321 [12.3%] vs. nonstatin: 389/3,321 [11.7%]), pneumonia (44/3,321 [1.3%] vs. 54/3,321 [1.6%]), and in-hospital mortality (52/3,321 [1.6%] vs. 43/3,321 [1.3%]). The estimated odds ratio was 1.06 (98.3% CI, 0.88 to 1.27) for prolonged ventilation, 0.81 (0.50 to 1.32) for pneumonia, and 1.21 (0.74 to 1.99) for in-hospital mortality. Neurologic outcomes were not associated with preoperative statin use (53/3,321 [1.6%] vs. 56/3,321 [1.7%]), with an odds ratio of 0.95 (0.60 to 1.50). The length of intensive care unit and hospital stay was also not associated with preoperative statin use, with a hazard ratio of 1.04 (0.98 to 1.10) for length of hospital stay and 1.00 (0.94 to 1.06) for length of intensive care unit stay.

Conclusions: Preoperative statin use did not reduce pulmonary or neurologic complications after cardiac surgery.