title: 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.affiliation: Department of Surgical and Morphological Sciences, Cardiac Surgery Unit, Varese University Hospital, University of Insubria, Varese, Italy. giovannimariscalco@yahoo.it
authors.forename: Giovanni
authors.initials: G
authors.lastname: Mariscalco
authors.forename: Marzia
authors.initials: M
authors.lastname: Cottini
authors.forename: Marco
authors.initials: M
authors.lastname: Zanobini
authors.forename: Stefano
authors.initials: S
authors.lastname: Salis
authors.forename: Carmelo
authors.initials: C
authors.lastname: Dominici
authors.forename: Maciej
authors.initials: M
authors.lastname: Banach
authors.forename: Francesco
authors.initials: F
authors.lastname: Onorati
authors.forename: Gabriele
authors.initials: G
authors.lastname: Piffaretti
authors.forename: Giovanna
authors.initials: G
authors.lastname: Covaia
authors.forename: Marco
authors.initials: M
authors.lastname: Realini
authors.forename: Cesare
authors.initials: C
authors.lastname: Beghi
mesh_terms: D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D016001:Confidence Intervals; D017023:Coronary Angiography / Q000379:methods; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*; D003693:Delirium / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D015994:Incidence; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors