Redelmeier DA, Thiruchelvam D, Daneman N. Delirium Following Elective Surgery in Elderly Patients Receiving Statins. Can Med Assoc J 2008 Sep 23;179(7):645-652.
http://www.cmaj.ca/cgi/content/abstract/179/7/645
http://www.cmaj.ca/cgi/content/full/179/7/645
http://www.cmaj.ca/cgi/reprint/179/7/645.pdf
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© 2008 Canadian Medical Association or its licensors
All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association.
Research
Delirium after elective surgery among elderly patients taking statins
Donald A. Redelmeier, MD MSHSR, Deva Thiruchelvam, MSc and Nick Daneman, MD
From the Departments of Medicine, Infectious Disease, and Health Policy Management and Evaluation (Redelmeier, Daneman), University of Toronto; Clinical Epidemiology and Health Care Research Program (Daneman), and the Division of General Internal Medicine (Redelmeier), Sunnybrook Health Sciences Centre; and the Institute for Clinical Evaluative Sciences in Ontario (Redelmeier, Daneman, Thiruchelvam), Toronto, Ont.
Correspondence to: Dr. Donald A. Redelmeier, Sunnybrook Health Sciences Centre, Rm. G-151, 2075 Bayview Ave., Toronto ON M4N 3M5; fax 416 480-6048;
Background: Postoperative delirium after elective surgery is frequent and potentially serious. We sought to determine whether the use of statin medications was associated with a higher risk of postoperative delirium than other medications that do not alter microvascular autoregulation.
Methods: We conducted a retrospective cohort analysis of 284 158 consecutive patients in Ontario aged 65 years and older who were admitted for elective surgery. We identified exposure to statins from outpatient pharmacy records before admission. We identified delirium by examining hospital records after surgery.
Results: About 7% (n = 19 501) of the patients were taking statins. Overall, 3195 patients experienced postoperative delirium; the rate was significantly higher among patients taking statins (14 per 1000) than among those not taking statins (11 per 1000) (odds ratio [OR] 1.30, 95% confidence interval [CI] 1.15–1.47, p
Interpretation: The use of statins is associated with an increased risk of postoperative delirium among elderly patients undergoing elective surgery.
Copyright 1995-2008, Canadian Medical Association.
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Marcantonio ER. Statins and postoperative delirium. Can Med Assoc J 2008 Sep 23;179(7):627-628. (Editorial)
http://www.cmaj.ca/cgi/content/full/179/7/627
http://www.cmaj.ca/cgi/reprint/179/7/627.pdf