Preoperative statin administration does not protect against early postoperative acute respiratory distress syndrome (ARDS): A retrospective cohort study

Background: Postoperative ARDS has mortality exceeding 45% in certain surgical populations. Statins have been shown to possess immunomodulatory and anti-inflammatory effects. The objective of this study was to determine if preoperative statin therapy is associated with a reduced frequency of postoperative ARDS in targeted surgical populations at increased risk of developing ARDS. Methods: A retrospective cohort evaluation of the association between preoperative statin therapy and postoperative ARDS was performed. The study population included consecutive patients undergoing elective high-risk thoracic and aortic vascular surgery. The association between preoperative statins and postoperative ARDS was first assessed with univariate analyses. To control for confounding factors a propensity-adjusted multivariate logistic regression analysis was then performed. Results: Out of 1845 surgical patients, 722 were receiving perioperative statin therapy. 120 patients developed ARDS. The frequency of ARDS among those who were receiving statin therapy versus those who were not was 7.2% vs. 6.1% (OR = 1.20, 95% CI = 0.83 – 1.75; p = 0.33). After adjusting for the propensity to receive statin therapy as well as other confounding variables, statins were not associated with a reduced frequency of ARDS (OR 1.02, 95% CI = 0.65 – 1.62; p = 0.93). Conclusions: In patients undergoing high-risk thoracic and aortic vascular surgery, preoperative statin therapy was not associated with a reduction in early postoperative ARDS. These results do not support the use of statins as an ARDS preventative measure in patients undergoing high-risk surgery.