Use of Statins in Adhesive Small Bowel Obstruction

• Published in: The Journal of surgical research 2010-07, Vol.162 (1), p.17-21
• Main Authors: Srinivasa, Sanket, M.B.Ch.B, Kahokehr, Arman A., B.H.B., M.B.Ch.B, Sammour, Tarik, B.H.B., M.B.Ch.B, Yu, Tzu-Chieh, B.H.B., M.B.Ch.B, Abbas, Saleh M., M.B.B.S., F.R.A.C.S, Hill, Andrew G., M.D., F.R.A.C.S
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Female; Gastroenterology. Liver. Pancreas. Abdomen; General aspects; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Intestinal Obstruction - drug therapy; Intestine, Small - physiopathology; Male; Medical sciences; Middle Aged; Other diseases. Semiology; Retrospective Studies; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Surgery; Tissue Adhesions - drug therapy; Young Adult
• ISSN: 0022-4804; 1095-8673
• DOI: 10.1016/j.jss.2010.02.028

Background Adhesive small bowel obstruction (ASBO) causes considerable morbidity and may require surgical intervention. The role of statins in adhesion prevention is of increasing interest, though no investigation of its impact on ASBO and operative rates has been conducted. This study investigates the impact of statin use on operative rates in ASBO. Methods A retrospective review of all patients with ASBO within our institution from January 1997 to December 2007 was conducted. Demographic data, potential confounders, and treatment received (conservative/operative) were recorded. Statistical significance was determined using the two-tailed Fisher's exact test for categorical data and the Mann-Whitney U test for continuous data. Univariate and logistic regression were conducted to control for potential known confounders. Results There were 419 cases of ASBO with 253 (60.4%) females. The median age of diagnosis was 62 (15–93) years and the median ASA score was 2 (1–4). Forty-nine (11.7%) patients required operative management, the median day-stay was three (1–154) d and 151 (36%) patients were taking statins. On univariate analysis, statin use was associated with decreased operative rates ( P = 0.02). The relative risk was 0.46 with an absolute risk reduction of 7.9% (95% CI: 2.1%–13.7%). The number needed to treat was 13 (NNT = 13; 95% CI: 7.3–46.8). Statin use was associated with decreased operative rates using a logistic regression model ( P = 0.04). Conclusion Statin use is independently associated with decreased operative rates in ASBO.