Abstract
AimTo assess whether preoperative statin therapy is associated with the risk of postoperative infection in patients undergoing cardiac surgery.Methods520 patients undergoing cardiac surgery in 2010 were retrospectively examined. Data regarding statin and antibiotic use prior to and after surgery were available from the hospital pharmacy information system. Cultures and clinical data of patients on postoperative antibiotics other than standard prophylactic therapy were studied to identify postoperative infections up to 30 days from day of surgery.Results370 (71.2 %) patients were on preoperative statin therapy. Overall, 82 patients (15.8 %) suffered from postoperative infection of which 11 were surgical site infections. In multivariable regression analysis, statin therapy was associated with a reduced risk of postoperative infection (adjusted odds ratio: 0.329, 95 %: CI 0.19–0.57; P < 0.001).ConclusionsPreoperative statin use was associated with a considerable reduced risk of postoperative infections following cardiac surgery. Randomised controlled trials are required to clarify the role of statin therapy in the prevention of postoperative infections.
Highlights
Approximately 16,000 patients are scheduled for cardiothoracic surgery in the Netherlands. [1] Postoperative infections are important causes of increased length of hospital stay and mortality
Postoperative initiation of statin therapy was not associated with a reduced risk of infection (AOR: 0.676, 95 % confidence intervals (CI): 0.26–1.75; P=0.422). In this cohort of 520 patients undergoing cardiac surgery, preoperative statin therapy was associated with a 67 % reduced risk of a postoperative infectious complication
The reduction in postoperative infection by preoperative statin use was mainly caused by a reduction in nonsurgical site infections, in particular less pneumonia and urinary tract infections
Summary
Approximately 16,000 patients are scheduled for cardiothoracic surgery in the Netherlands. [1] Postoperative infections are important causes of increased length of hospital stay and mortality. [1] Postoperative infections are important causes of increased length of hospital stay and mortality. The incidence of postoperative infectious complications is 5 to 21 % [2,3,4]. In a search for additional ways to decrease the postoperative infection rate, statin therapy is gaining increasing attention. In addition to cholesterol-lowering characteristics, statins have anti-inflammatory, immunomodulatory, antioxidant and antiapoptotic effects that could alter the response to infections. [5] Whether statins have a beneficial effect on postoperative infectious complications in patients undergoing cardiac surgery is unknown, as prior studies have shown conflicting results [6,7,8]. This study aims to assess whether preoperative statin therapy is associated with the risk of postoperative infection in patients undergoing cardiac surgery In addition to cholesterol-lowering characteristics, statins have anti-inflammatory, immunomodulatory, antioxidant and antiapoptotic effects that could alter the response to infections. [5] Whether statins have a beneficial effect on postoperative infectious complications in patients undergoing cardiac surgery is unknown, as prior studies have shown conflicting results [6,7,8].
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