Department of Surgery, St. Joseph Mercy Hospital Ann Arbor, Ann Arbor, MI, USA.
Department of Surgery, William Beaumont Hospital Troy, Troy, MI, USA.
Am J Surg. 2018 Jul;216(1):31-36. doi: 10.1016/j.amjsurg.2018.01.024. Epub 2018 Jan 31.
This study was designed to determine the effect of statins on colorectal postoperative complications related to sepsis. Previous studies have reported conflicting results.
This is a retrospective propensity score analysis of postoperative outcomes from a large regional database of patients who underwent elective colorectal resection from June 2012-July 2015.
7285 patients met inclusion criteria: 34.5% received statins. Propensity score matching revealed that patients taking statins had reduced risk of sepsis (3.75% vs 5.32%, p = .03). Subgroup analysis revealed that this difference was driven by patients undergoing rectal resections. Among the rectal resection group, anastomotic leaks were more common in the non-statins group (4.1% vs. 1.3%, p = .01). There was no significant difference between those taking statins and those not on statin medications with respect to composite SSI or 30-day mortality.
Statin medications are associated with decreased risk of sepsis after colorectal surgery and anastomotic leaks after rectal resection. Future studies should focus on medication type, dosage, and duration to confirm these results and identify patient populations that would benefit most from statin therapy.
本研究旨在确定他汀类药物对与脓毒症相关的结直肠术后并发症的影响。先前的研究结果存在矛盾。
这是一项回顾性倾向评分分析，对 2012 年 6 月至 2015 年 7 月期间接受择期结直肠切除术的患者的术后结局进行了分析。
7285 例患者符合纳入标准：34.5%接受了他汀类药物治疗。倾向评分匹配显示，服用他汀类药物的患者发生脓毒症的风险降低（3.75%比 5.32%，p=0.03）。亚组分析显示，这种差异是由接受直肠切除术的患者驱动的。在直肠切除术组中，非他汀类药物组吻合口漏的发生率更高（4.1%比 1.3%，p=0.01）。服用他汀类药物与未服用他汀类药物的患者在复合 SSI 或 30 天死亡率方面无显著差异。
他汀类药物与结直肠手术后脓毒症以及直肠切除术后吻合口漏的风险降低相关。未来的研究应关注药物类型、剂量和持续时间，以证实这些结果，并确定最受益于他汀类药物治疗的患者人群。
