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Published on: February 27, 2018
Delirium after elective surgery among elderly patients taking statins
Donald A Redelmeier1, Deva Thiruchelvam, Nick Daneman
1Department of Medicine, University of Toronto, Ontario, Toronto, Canada. dar@ices.on.ca
Summary
Statin use is linked to a higher risk of postoperative delirium in elderly patients undergoing elective surgery. This finding highlights a potential concern for this patient group and medication class.
Area of Science:
- Geriatric Medicine
- Pharmacology
- Surgical Outcomes
Background:
- Postoperative delirium is a common and serious complication following elective surgery.
- The role of medications, particularly statins, in the risk of postoperative delirium requires investigation.
Purpose of the Study:
- To determine if statin use is associated with an increased risk of postoperative delirium compared to non-statin medications.
- To compare the risk of delirium associated with statins to other factors like surgical duration.
Main Methods:
- Retrospective cohort analysis of 284,158 patients aged 65+ undergoing elective surgery in Ontario.
- Exposure to statins identified from outpatient pharmacy records prior to admission.
- Postoperative delirium identified through hospital record examination.
Main Results:
- Approximately 7% of patients were taking statins.
- The rate of postoperative delirium was significantly higher in statin users (14 per 1000) versus non-users (11 per 1000).
- This increased risk persisted after adjusting for multiple factors and was higher than the risk associated with a 30-minute surgery extension.
Conclusions:
- Statin use is associated with an elevated risk of postoperative delirium in elderly patients undergoing elective surgery.
- The association was observed across various surgical types and delirium complexities.
- No increased risk of delirium was found with 20 other cardiac or noncardiac medications.
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