Preoperative statin therapy is not associated with a decrease in the incidence of delirium after cardiac operations

Giovanni Mariscalco, Marzia Cottini, Marco Zanobini, Stefano Salis, Carmelo Dominici, MacIej Banach, Francesco Onorati, Gabriele Piffaretti, Giovanna Covaia, Marco Realini, Cesare Beghi

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)1439-1448
Number of pages10
JournalAnnals of Thoracic Surgery
Volume93
Issue number5
DOIs
Publication statusPublished - May 2012

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Delirium
Incidence
Coronary Artery Bypass
Odds Ratio
Confidence Intervals
Therapeutics
Intensive Care Units
Confusion
Propensity Score
Hospital Mortality
Cardiopulmonary Bypass
Length of Stay
Age Groups
Morbidity
Control Groups

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

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Preoperative statin therapy is not associated with a decrease in the incidence of delirium after cardiac operations. / Mariscalco, Giovanni; Cottini, Marzia; Zanobini, Marco; Salis, Stefano; Dominici, Carmelo; Banach, MacIej; Onorati, Francesco; Piffaretti, Gabriele; Covaia, Giovanna; Realini, Marco; Beghi, Cesare.

In: Annals of Thoracic Surgery, Vol. 93, No. 5, 05.2012, p. 1439-1448.

Research output: Contribution to journalArticle

Mariscalco, G, Cottini, M, Zanobini, M, Salis, S, Dominici, C, Banach, M, Onorati, F, Piffaretti, G, Covaia, G, Realini, M & Beghi, C 2012, 'Preoperative statin therapy is not associated with a decrease in the incidence of delirium after cardiac operations', Annals of Thoracic Surgery, vol. 93, no. 5, pp. 1439-1448. https://doi.org/10.1016/j.athoracsur.2012.02.012
Mariscalco, Giovanni ; Cottini, Marzia ; Zanobini, Marco ; Salis, Stefano ; Dominici, Carmelo ; Banach, MacIej ; Onorati, Francesco ; Piffaretti, Gabriele ; Covaia, Giovanna ; Realini, Marco ; Beghi, Cesare. / Preoperative statin therapy is not associated with a decrease in the incidence of delirium after cardiac operations. In: Annals of Thoracic Surgery. 2012 ; Vol. 93, No. 5. pp. 1439-1448.
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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.",
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T1 - Preoperative statin therapy is not associated with a decrease in the incidence of delirium after cardiac operations

AU - Mariscalco, Giovanni

AU - Cottini, Marzia

AU - Zanobini, Marco

AU - Salis, Stefano

AU - Dominici, Carmelo

AU - Banach, MacIej

AU - Onorati, Francesco

AU - Piffaretti, Gabriele

AU - Covaia, Giovanna

AU - Realini, Marco

AU - Beghi, Cesare

PY - 2012/5

Y1 - 2012/5

N2 - 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.

AB - 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.

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