Effect of pre-operative statin administration on delirium rate after coronary artery bypass grafting (CABG): a prospective cohort study

Statins have recently been suggested to exert protective cerebral effects in patients undergoing
cardiac surgery.
Objective: The aim of this study was to determine the association between pre-operative statin administration
and the rate of post-operative delirium (POD) in patients undergoing coronary artery bypass grafting (CABG).
Methods: This prospective cohort study was conducted at Seyedoshohada Hospital (Urmia, Iran) from June 2017
through April 2018. Patients, before undergoing CABG may have two different approaches by clinicians;
administrating statins vs. those who do not receive statins. Participants in this study were selected among each of
the two approaches. Therefore, Group A (n=200) (exposure group) received statins 10 mg or 20 mg in the preoperative
period and Group B (n=200) did not receive statins before admission to hospital. During their intensive
care unit (ICU) stay, Confusion Assessment Method (CAM) was performed every 8 hours to assess delirium. The
data were analyzed by STATA version 13. The rate of POD were determined across the groups using
independent samples t-test and Chi-square tests. Study covariates were adjusted and the association between the
outcome of delirium incidence and clinical interventions was examined using multiple logistic regression.
Results: Demographic data was similar between the two groups. Of the four hundred patients analyzed, 57
patients (14.5%) had delirium at some time during their cardiovascular ICU stay; nine (4.5%) in the patients
group with use of statins and forty-eight (24%) in the patients group without use of statins had POD. There was a
significant difference in the occurrence of delirium across the two groups (p=0.001). Incidence of POD in
patients ≥ 60 years in Group A was significantly lower than in the patients in Group B, 4.2% and 32.3%
respectively (p=0.001).
Conclusion: Statin Pretreatment reduces the occurrence of post-operative delirium after coronary artery bypass
surgery.