Introduction

1. Review of recent studies shows that statins protect the heart and brain against ischemic injury (1) can decrease post operative arrhythmias and in large population-based studies statins are associated with a reduced risk of pneumonia (2) In 16 trials in over 50, 000 cases, the mortality from infection was 5% in statin patients as compared to 19% in controls. Statins have been shown to reduce the risk of venous thrombo-embolism (VTE) (5) Short-term high-dose statin pretreatment protects the kidneys, decreasing the level of serum creatine and reducing the rate of contrast-induced nephropathy in patients undergoing procedures requiring contrast media (6) Short term statin treatment has been shown to attenuate lipo-polysaccharide-induced acute lung injury (7) finally to have significant analgesic effects (8) Introduction Example Arch Surg. 2012 Feb;147(2):181-9. archsurg.2011 Effect of perioperative statins on death, myocardial infarction, atrial fibrillation, and length of stay: a systematic review and meta-analysis. Chopra V, Wesorick DH, Sussman JB, Greene T, Rogers M, Froehlich JB, Eagle KA, Saint S. Division of General Internal Medicine, University of Michigan Health System, Ann Arbor, MI 48109, USA. vineetc@umich.edu CONCLUSIONS: Perioperative statin treatment in statin-naive patients reduces atrial fibrillation, myocardial infarction, and duration of hospital stay. Wider use of statins to improve cardiac outcomes in patients undergoing high-risk procedures seems warranted. Conclusions Obesity and hyperlipidemia are common in surgical patients and associated with postoperative complications. Surgeons need to recognize that statin treatment is significantly underutilized and most if not all obese diabetics are likely candidates for statin treatment. A growing body of research suggests that statin treatment is likely to significantly decrease a wide spectrum of serious postoperative complications in surgical patients. Appropriate, aggressive use of preoperative statins should be considered in patients following present guidelines. The expectation that these patients are likely to sustain lower rates of postoperative complications including: MI, CVA, VTE, arrhythmia, infections, lung and renal injury and improved analgesia Present guidelines recommend the administration of statins to very large population of surgical patients but studies show there is significant underutilization of statins in US clinical practice. Obesity is directly related to type II diabetes mellitus and hyperlipidemia and both are common in surgical patients and associated with increased risks of complications In one study (4) nearly all diabetics were candidates for statin Rx but more than a third were untreated. Dr. Rutledge, Center for Laparoscopic Obesity Surgery Tel: +1-702 714 0011, E-mail: drr@clos.net Please Note: I have 18 presentations (14 oral and 4 posters) If I am not present please email or Call me and I will be right back. DrR Preoperative Statins & Peri-Operative Complications