Influence of statins on postoperative wound complications after inguinal or ventral herniorrhaphy |
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Authors: | M Hauer-Jensen C Fort J L Mehta L M Fink |
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Institution: | (1) Department of Surgery, Central Arkansas Veterans Healthcare System and University of Arkansas for Medical Sciences, 4301 West Markham, Slot 725, Little Rock, AR, 72205, USA;(2) Department of Pathology, Central Arkansas Veterans Healthcare System and University of Arkansas for Medical Sciences, 4301 West Markham, Slot 725, Little Rock, AR, 72205, USA;(3) Department of Internal Medicine, Central Arkansas Veterans Healthcare System and University of Arkansas for Medical Sciences, 4301 West Markham, Slot 725, Little Rock, AR, 72205, USA |
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Abstract: | The lipid-lowering agents, statins, are the most commonly prescribed class of drugs in the western world. Because of their
widespread use, many patients undergo surgical procedures while on statins. Statins, in addition to cholesterol-lowering effects,
also have anticoagulant, immunosuppressive, and antiproliferative properties that may affect the risk of local wound complications.
This study investigated the relationship between statins and postoperative wound complications in a large cohort of patients
undergoing inguinal or ventral hernia repair. Data mining was performed in the Veterans Integrated Service Network (VISN)16
Data Warehouse. This database contains clinical and demographic information about all veterans cared for at the ten VA Medical
Centers that comprise the South Central VA Healthcare Network in the mid-south region of the US. Aggregate data (age, body
mass index, smoking history, gender, race, history of diabetes, statin use, and postoperative wound complications) were obtained
for all patients who underwent inguinal or ventral hernia repair during the period October 1, 1996–November 30, 2004. During
the period of the query, 10,782 patients (10,676 male, 106 female), 1,242 (11.5%) of whom received statins, underwent herniorrhaphy.
Statin use did not affect the risk of wound infection or delayed wound healing. Statin use was, however, associated with an
increased rate of local postoperative bleeding complications (P=0.01). When the type of hernia, age, smoking, diabetes, and body mass index were included in a multivariate analysis, statins
remained borderline significant as an independent predictor of wound hematoma/postoperative bleeding (P=0.04), odds ratio 1.6 (95% CI 1.03–2.44). Patients who undergo inguinal herniorrhaphy while on statins have an increased
risk of postoperative wound hematoma/hemorrhage. Focus on additional factors that may affect the propensity to postoperative
bleeding and on meticulous intraoperative hemostasis are particularly important in such patients. |
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Keywords: | Hydroxymethylglutaryl-CoA reductase inhibitors Hernia inguinal Hernia ventral Postoperative complications Postoperative hemorrhage |
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