Preoperative statin therapy is associated with improved outcomes and resource utilization in patients undergoing aortic aneurysm repair

Michael M. McNally, Steven Agle, Frank M. Parker, William M. Bogey, Charles S. Powell, Michael C. Stoner

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

Introduction: This study hypothesized that preoperative statin therapy would have a protective effect on patients undergoing elective abdominal aortic aneurysm (AAA) repair and that the risk-reduction effect of these agents would result in a reduction in subsequent total hospital costs. Methods: All patients who underwent an elective endovascular AAA repair (EVAR) or open AAA repair (OAR) between 2004 and 2007 were retrospectively reviewed. Clinical end points included postoperative days, length of hospital stay, postoperative complications (myocardial infarction, stroke, renal failure, hemorrhage, pneumonia, urinary tract infection, wound infection), and 30-day mortality. The financial end point was total hospital cost associated with the procedure. Results: We identified 401 patients, consisting of 173 EVAR patients (43%) and 228 OAR (57%). Despite a higher Society for Vascular Surgery risk score, the EVAR statin cohort had significantly reduced postoperative days (1.9 ± 0.2 vs 2.3 ± 0.3, P <.05) and hospital length of stay (2.3 ± 0.3 vs 2.8 ± 0.4, P <.05) compared with the nonstatin EVAR cohort. Postoperative complications (4.4% vs 14.7%, P <.05) and the mortality rate (0.0% vs 5.9%, P <.05) were significantly decreased in the OAR statin cohort compared with the nonstatin OAR cohort and trended to be decreased in the EVAR statin group. Statin therapy translated into a lower total cost per patient of $3,205 for EVAR and $3,792 for OAR (P <.05). Conclusion: With respect to both clinical outcome measures and subsequent resource utilization, statin therapy is associated with a beneficial effect in patients undergoing elective AAA repair. These data suggest that preoperative statin therapy should be an integral part of the risk optimization for patients undergoing AAA repair.

Original languageEnglish (US)
Pages (from-to)1390-1396
Number of pages7
JournalJournal of Vascular Surgery
Volume51
Issue number6
DOIs
StatePublished - Jun 2010
Externally publishedYes

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Aortic Aneurysm
Abdominal Aortic Aneurysm
Length of Stay
Hospital Costs
Therapeutics
Mortality
Wound Infection
Risk Reduction Behavior
Urinary Tract Infections
Renal Insufficiency
Pneumonia
Stroke
Myocardial Infarction
Outcome Assessment (Health Care)
Hemorrhage
Costs and Cost Analysis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Preoperative statin therapy is associated with improved outcomes and resource utilization in patients undergoing aortic aneurysm repair. / McNally, Michael M.; Agle, Steven; Parker, Frank M.; Bogey, William M.; Powell, Charles S.; Stoner, Michael C.

In: Journal of Vascular Surgery, Vol. 51, No. 6, 06.2010, p. 1390-1396.

Research output: Contribution to journalArticle

McNally, Michael M. ; Agle, Steven ; Parker, Frank M. ; Bogey, William M. ; Powell, Charles S. ; Stoner, Michael C. / Preoperative statin therapy is associated with improved outcomes and resource utilization in patients undergoing aortic aneurysm repair. In: Journal of Vascular Surgery. 2010 ; Vol. 51, No. 6. pp. 1390-1396.
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abstract = "Introduction: This study hypothesized that preoperative statin therapy would have a protective effect on patients undergoing elective abdominal aortic aneurysm (AAA) repair and that the risk-reduction effect of these agents would result in a reduction in subsequent total hospital costs. Methods: All patients who underwent an elective endovascular AAA repair (EVAR) or open AAA repair (OAR) between 2004 and 2007 were retrospectively reviewed. Clinical end points included postoperative days, length of hospital stay, postoperative complications (myocardial infarction, stroke, renal failure, hemorrhage, pneumonia, urinary tract infection, wound infection), and 30-day mortality. The financial end point was total hospital cost associated with the procedure. Results: We identified 401 patients, consisting of 173 EVAR patients (43{\%}) and 228 OAR (57{\%}). Despite a higher Society for Vascular Surgery risk score, the EVAR statin cohort had significantly reduced postoperative days (1.9 ± 0.2 vs 2.3 ± 0.3, P <.05) and hospital length of stay (2.3 ± 0.3 vs 2.8 ± 0.4, P <.05) compared with the nonstatin EVAR cohort. Postoperative complications (4.4{\%} vs 14.7{\%}, P <.05) and the mortality rate (0.0{\%} vs 5.9{\%}, P <.05) were significantly decreased in the OAR statin cohort compared with the nonstatin OAR cohort and trended to be decreased in the EVAR statin group. Statin therapy translated into a lower total cost per patient of $3,205 for EVAR and $3,792 for OAR (P <.05). Conclusion: With respect to both clinical outcome measures and subsequent resource utilization, statin therapy is associated with a beneficial effect in patients undergoing elective AAA repair. These data suggest that preoperative statin therapy should be an integral part of the risk optimization for patients undergoing AAA repair.",
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T1 - Preoperative statin therapy is associated with improved outcomes and resource utilization in patients undergoing aortic aneurysm repair

AU - McNally, Michael M.

AU - Agle, Steven

AU - Parker, Frank M.

AU - Bogey, William M.

AU - Powell, Charles S.

AU - Stoner, Michael C.

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N2 - Introduction: This study hypothesized that preoperative statin therapy would have a protective effect on patients undergoing elective abdominal aortic aneurysm (AAA) repair and that the risk-reduction effect of these agents would result in a reduction in subsequent total hospital costs. Methods: All patients who underwent an elective endovascular AAA repair (EVAR) or open AAA repair (OAR) between 2004 and 2007 were retrospectively reviewed. Clinical end points included postoperative days, length of hospital stay, postoperative complications (myocardial infarction, stroke, renal failure, hemorrhage, pneumonia, urinary tract infection, wound infection), and 30-day mortality. The financial end point was total hospital cost associated with the procedure. Results: We identified 401 patients, consisting of 173 EVAR patients (43%) and 228 OAR (57%). Despite a higher Society for Vascular Surgery risk score, the EVAR statin cohort had significantly reduced postoperative days (1.9 ± 0.2 vs 2.3 ± 0.3, P <.05) and hospital length of stay (2.3 ± 0.3 vs 2.8 ± 0.4, P <.05) compared with the nonstatin EVAR cohort. Postoperative complications (4.4% vs 14.7%, P <.05) and the mortality rate (0.0% vs 5.9%, P <.05) were significantly decreased in the OAR statin cohort compared with the nonstatin OAR cohort and trended to be decreased in the EVAR statin group. Statin therapy translated into a lower total cost per patient of $3,205 for EVAR and $3,792 for OAR (P <.05). Conclusion: With respect to both clinical outcome measures and subsequent resource utilization, statin therapy is associated with a beneficial effect in patients undergoing elective AAA repair. These data suggest that preoperative statin therapy should be an integral part of the risk optimization for patients undergoing AAA repair.

AB - Introduction: This study hypothesized that preoperative statin therapy would have a protective effect on patients undergoing elective abdominal aortic aneurysm (AAA) repair and that the risk-reduction effect of these agents would result in a reduction in subsequent total hospital costs. Methods: All patients who underwent an elective endovascular AAA repair (EVAR) or open AAA repair (OAR) between 2004 and 2007 were retrospectively reviewed. Clinical end points included postoperative days, length of hospital stay, postoperative complications (myocardial infarction, stroke, renal failure, hemorrhage, pneumonia, urinary tract infection, wound infection), and 30-day mortality. The financial end point was total hospital cost associated with the procedure. Results: We identified 401 patients, consisting of 173 EVAR patients (43%) and 228 OAR (57%). Despite a higher Society for Vascular Surgery risk score, the EVAR statin cohort had significantly reduced postoperative days (1.9 ± 0.2 vs 2.3 ± 0.3, P <.05) and hospital length of stay (2.3 ± 0.3 vs 2.8 ± 0.4, P <.05) compared with the nonstatin EVAR cohort. Postoperative complications (4.4% vs 14.7%, P <.05) and the mortality rate (0.0% vs 5.9%, P <.05) were significantly decreased in the OAR statin cohort compared with the nonstatin OAR cohort and trended to be decreased in the EVAR statin group. Statin therapy translated into a lower total cost per patient of $3,205 for EVAR and $3,792 for OAR (P <.05). Conclusion: With respect to both clinical outcome measures and subsequent resource utilization, statin therapy is associated with a beneficial effect in patients undergoing elective AAA repair. These data suggest that preoperative statin therapy should be an integral part of the risk optimization for patients undergoing AAA repair.

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