title: Preoperative statin administration does not protect against early postoperative acute respiratory distress syndrome: a retrospective cohort study.
abstract: BACKGROUND
  Statins have been shown to possess antiinflammatory and immunomodulatory effects. In this study, we sought to determine if preoperative statin therapy is associated with a reduced frequency of postoperative acute respiratory distress syndrome (ARDS) in surgical populations at increased risk of developing ARDS.
  
  
  METHODS
  We performed a retrospective cohort evaluation of the association between preoperative statin therapy and early postoperative ARDS in patients undergoing elective high-risk thoracic and aortic vascular surgery. The association between preoperative statin therapy and postoperative ARDS was assessed using propensity-adjusted analyses to control for indication bias and confounding factors.
  
  
  RESULTS
  Of 1845 patients, 722 were receiving preoperative statin therapy. One hundred twenty patients developed postoperative ARDS. Frequencies of ARDS among those receiving statin therapy versus those who were not was 7.2% and 6.1%, respectively (OR = 1.20; 95% CI, 0.83-1.75; P = 0.330). Neither the stratified propensity score analysis (pooled OR 0.93; 95% CI, 0.60-1.43) nor matched analysis (OR = 0.78; 95% CI, 0.48-1.27) identified a statistically significant association between preoperative statin administration and postoperative ARDS. When compared to matched controls, patients who developed postoperative ARDS did not differ in mortality (7.7% vs 8.8%, P = 0.51), hospital length of stay (21 days vs 15 days, P = 0.21), or ventilator-free days (24 days vs 25 days, P = 0.62).
  
  
  CONCLUSIONS
  In patients undergoing high-risk surgery, preoperative statin therapy was not associated with a statistically significant reduction in postoperative ARDS. These results do not support the use of statins as prophylaxis against ARDS in patients undergoing high-risk surgery.
authors: From the Departments of Pulmonary and Critical Care Medicine, Health Sciences Research, Anesthesiology, Division of Vascular Surgery, Department of Surgery, and Division of Thoracic Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota.
authors: Hemang
authors: H
authors: Yadav
authors: Ravi K
authors: RK
authors: Lingineni
authors: Ericka J
authors: EJ
authors: Slivinski
authors: Katie A
authors: KA
authors: Stockler
authors: Arun
authors: A
authors: Subramanian
authors: Gustavo S
authors: GS
authors: Oderich
authors: Dennis A
authors: DA
authors: Wigle
authors: Rickey E
authors: RE
authors: Carter
authors: Daryl J
authors: DJ
authors: Kor
mesh_terms: D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control*; D011300:Preoperative Care / Q000379:methods*; D012128:Respiratory Distress Syndrome / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors