Published online Jul 26, 2021. doi: 10.12998/wjcc.v9.i21.5909
Peer-review started: March 30, 2021
First decision: April 28, 2021
Revised: May 4, 2021
Accepted: June 7, 2021
Article in press: June 7, 2021
Published online: July 26, 2021
Our previous basic research study found that statins exert pleiotropic effects, including anti-inflammatory and antioxidative stress effects, inhibition of platelet aggregation, and promotion of neuroprotection. The anti-delirium role of statins was not clearly determined in recent studies.
Delirium is a severe clinical syndrome characterized by a temporary organic mental disorder, which may induce long-term cognitive impairment, death/disability, and increased length of hospital stay and costs. An increasing number of basic research studies indicate that statins play an important role in postoperative delirium. Our preliminary clinical experiment also revealed that perioperative rosuvastatin had potential value as a treatment for postoperative delirium.
This randomized, double-blind, and placebo-controlled trial explored the anti-delirium effect of perioperative rosuvastatin and compared the clinical efficacy and economic efficiency, as well as the safety of perioperative rosuvastatin, in elderly patients who underwent surgery under general anesthesia.
This randomized, double-blind, and placebo-controlled trial was conducted in a single center and enrolled patients aged more than 60 years who underwent an elective operation under general anesthesia. The patients were randomly assigned to receive either rosuvastatin (40 mg/d) or placebo.
The final analysis included 411 patients in the placebo group and 410 patients in the rosuvastatin group. The incidence of postoperative delirium was significantly lower in the rosuvastatin group than in the placebo group (P < 0.05). No significant difference in 30-d all-cause mortality was observed between the two groups (P > 0.05). Rosuvastatin decreased the hospitalization time and hospitalization expenses (P < 0.057). No significant differences in abnormal liver enzyme levels or rhabdomyolysis were observed between the two groups (P > 0.05).
Perioperative rosuvastatin treatment potentially reduces the incidence of delirium after an elective operation under general anesthesia, without a higher incidence of drug-related complications.
In the future, a large prospective randomized investigation will definitively address the effect of rosuvastatin on postoperative delirium in elderly patients undergoing an elective operation under general anesthesia.