title: Preoperative statin therapy is associated with improved outcomes and resource utilization in patients undergoing aortic aneurysm repair.
abstract: BACKGROUND
  This study hypothesized that preoperative statin therapy would have a protective effect on patients undergoing elective abdominal aortic aneurysm (AAA) repair and that the risk-reduction effect of these agents would result in a reduction in subsequent total hospital costs.
  
  
  METHODS
  All patients who underwent an elective endovascular AAA repair (EVAR) or open AAA repair (OAR) between 2004 and 2007 were retrospectively reviewed. Clinical end points included postoperative days, length of hospital stay, postoperative complications (myocardial infarction, stroke, renal failure, hemorrhage, pneumonia, urinary tract infection, wound infection), and 30-day mortality. The financial end point was total hospital cost associated with the procedure.
  
  
  RESULTS
  We identified 401 patients, consisting of 173 EVAR patients (43%) and 228 OAR (57%). Despite a higher Society for Vascular Surgery risk score, the EVAR statin cohort had significantly reduced postoperative days (1.9 +/- 0.2 vs 2.3 +/- 0.3, P < .05) and hospital length of stay (2.3 +/- 0.3 vs 2.8 +/- 0.4, P < .05) compared with the nonstatin EVAR cohort. Postoperative complications (4.4% vs 14.7%, P < .05) and the mortality rate (0.0% vs 5.9%, P < .05) were significantly decreased in the OAR statin cohort compared with the nonstatin OAR cohort and trended to be decreased in the EVAR statin group. Statin therapy translated into a lower total cost per patient of $3,205 for EVAR and $3,792 for OAR (P < .05).
  
  
  CONCLUSIONS
  With respect to both clinical outcome measures and subsequent resource utilization, statin therapy is associated with a beneficial effect in patients undergoing elective AAA repair. These data suggest that preoperative statin therapy should be an integral part of the risk optimization for patients undergoing AAA repair.
authors.affiliation: Department of Cardiovascular Sciences, East Carolina University, Greenville, NC 27858-4354, USA.
authors.forename: Michael M
authors.initials: MM
authors.lastname: McNally
authors.forename: Steven C
authors.initials: SC
authors.lastname: Agle
authors.forename: Frank M
authors.initials: FM
authors.lastname: Parker
authors.forename: William M
authors.initials: WM
authors.lastname: Bogey
authors.forename: Charles S
authors.initials: CS
authors.lastname: Powell
authors.forename: Michael C
authors.initials: MC
authors.lastname: Stoner
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000191:economics / Q000401:mortality / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000191:economics / Q000401:mortality; D016009:Chi-Square Distribution; D003695:Delivery of Health Care / Q000191:economics / Q000706:statistics & numerical data*; D016527:Drug Costs; D017558:Elective Surgical Procedures; D005260:Female; D017721:Hospital Costs; D017052:Hospital Mortality; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000191:economics / Q000627:therapeutic use*; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D010043:Outcome and Process Assessment, Health Care / Q000191:economics; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors