Preoperative Statin Therapy Is Not Associated With a Decrease in the Incidence of Delirium After Cardiac Operations

• DOI: 10.1016/j.athoracsur.2012.02.012
• Publication Date: 2012-04-25T05:27:19Z
• Authors: Giovanni Mariscalco; Marzia Cottini; Marco Zanobini; Stefano Salis; Carmelo Dominici; Maciej Banach; Francesco Onorati; Gabriele Piffaretti; Giovanna Covaia; Marco Realini; Cesare Beghi
• Keywords: Male; 610; Coronary Angiography; intensive care unit; Cohort Studies; 03 medical and health sciences; delirium; drug activity; Postoperative Complications; 0302 clinical medicine; length of stay; coronary artery bypass graft; heart muscle revascularization; 616; Preoperative Care; Confidence Intervals; Odds Ratio; Humans; controlled study; human; Cardiology and Cardiovascular Medicine; Surgery; Pulmonary and Respiratory Medicine; Hospital Mortality; Coronary Artery Bypass; Aged; adult; Incidence; article; Age Factors; Coronary Stenosis; Delirium; Length of Stay; Middle Aged; 3. Good health; aged; female; Multivariate Analysis; Female; Hydroxymethylglutaryl-CoA Reductase Inhibitors; cardiopulmonary bypass

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