Statins and Postoperative Infections: A Randomized Clinical Trial

Abstract

Background:Observational studies, rather than randomized trials, revealed that statins might be associated with other benefits.Objectives:The present study aimed at evaluating the preventive effects of lovastatin when used as a prophylactic agent for early and late infective complications after surgery.Patients and Methods:A total of 149 patients undergoing elective intracranial and spinal surgeries, were enrolled in a double- blind randomized clinical trial in the department of neurosurgery of a teaching hospital. An amount of 20 mg lovastatin and the same dose of placebo, one day before the operation and three days after the surgery, were used for cases and controls, respectively. The patients were evaluated for local and systemic infections during hospitalization and 10, 30, 60 and 90 days after discharge.Results:A total of 149 patients, 78 men and 71 women with a mean age of 40.3 ± 16.5, were assigned to prophylactic protocols. 46 and 103 patients were in the case and control groups, respectively. Eight episodes of infection were detected, including six bacterial meningitis and two episodes of hospital- acquired pneumonia. All of the patients with documented postoperative infections were part of the placebo group, however, there were no significant statistical differences between the groups (P = 0.059).Conclusions:In spite of the differences between the two groups, the results did not significantly support the preventive effect of statins in postoperative infections.

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“…[7,[35][36][37][38] The most important characteristic of OA is a gradual degeneration of the joint cartilage, which is associated with bone hypertrophy (osteoporosis and subcutaneous bone sclerosis) and thickening of the joint capsule. [4,39,40] The American College of Rheumatology has identified the OA as a clinical syndrome which manifested with joint pain, morning stiffness, and joint crepitus. [8,9,41] Symptomatic knee OA is seen in about 13% of women and 10% of men at the age of 60 years or over.…”

Does short preoperative statin therapy prevent infectious complications in adults undergoing cardiac or non-cardiac surgery?

“…Patients of 2 studies underwent noncardiovascular surgery. 17 , 18 The total incidence of postoperative infections in the statin group was not significantly lower than in the placebo group (RR: 0.65, 95% CI: 0.23-1.79, p =0.40). Patients of 3 studies received atorvastatin treatment before surgery.…”

“…We included 5 studies in the analysis ( Figure 1 ). 14 - 18 Quality assessment, subject characteristics (such as age, gender, statins, and dose), and other treatment data of the included studies are presented in Table 1 . Three studies were of fairly good quality (Jadad score 3/5).…”

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“…This finding indicates that central obesity and decompensated heart failure can intensify the risk of OSA. [7,8,27,28] A definitive diagnosis of OSA is done by polysomnography, but this method is time-consuming and requires special laboratory measures, so OSA remains unknown and is not treated in most cases. This method is based on the number of abnormal breathing events that occur every hour of sleep, which is referred to as the apnea-hypopnea index (AHI).…”