Use of statins in adhesive small bowel obstruction.
BACKGROUND
Adhesive small bowel obstruction (ASBO) causes considerable morbidity and may require surgical intervention. The role of statins in adhesion prevention is of increasing interest, though no investigation of its impact on ASBO and operative rates has been conducted. This study investigates the impact of statin use on operative rates in ASBO.


METHODS
A retrospective review of all patients with ASBO within our institution from January 1997 to December 2007 was conducted. Demographic data, potential confounders, and treatment received (conservative/operative) were recorded. Statistical significance was determined using the two-tailed Fisher's exact test for categorical data and the Mann-Whitney U test for continuous data. Univariate and logistic regression were conducted to control for potential known confounders.


RESULTS
There were 419 cases of ASBO with 253 (60.4%) females. The median age of diagnosis was 62 (15-93) years and the median ASA score was 2 (1-4). Forty-nine (11.7%) patients required operative management, the median day-stay was three (1-154) d and 151 (36%) patients were taking statins. On univariate analysis, statin use was associated with decreased operative rates (P = 0.02). The relative risk was 0.46 with an absolute risk reduction of 7.9% (95% CI: 2.1%-13.7%). The number needed to treat was 13 (NNT = 13; 95% CI: 7.3-46.8). Statin use was associated with decreased operative rates using a logistic regression model (P = 0.04).


CONCLUSIONS
Statin use is independently associated with decreased operative rates in ASBO.
Srinivasa
Sanket
S
Department of Surgery, South Auckland Clinical School, University of Auckland, Auckland, New Zealand.
Kahokehr
Arman A
AA
Sammour
Tarik
T
Yu
Tzu-Chieh
TC
Abbas
Saleh M
SM
Hill
Andrew G
AG
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007415:Intestinal Obstruction / Q000188:drug therapy*; D007421:Intestine, Small / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000188:drug therapy; D055815:Young Adult
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors