Use of Statins in Adhesive Small Bowel Obstruction1

Srinivasa, Sanket; Kahokehr, Arman A.; Sammour, Tarik; Yu, Tzu-Chieh; Abbas, Saleh M.; Hill, Andrew G.

doi:10.1016/j.jss.2010.02.028

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Volume 162, Issue 1 , Pages 17-21, July 2010

Use of Statins in Adhesive Small Bowel Obstruction¹

Sanket Srinivasa, M.B.Ch.B.
- Department of Surgery, South Auckland Clinical School, University of Auckland, Auckland, New Zealand
- These authors are recipients of the Auckland Medical Research Foundation (AMRF) Ruth Spencer Medical Research Fellowship.
Arman A. Kahokehr, B.H.B., M.B.Ch.B.
- Department of Surgery, South Auckland Clinical School, University of Auckland, Auckland, New Zealand
- These authors are recipients of the Auckland Medical Research Foundation (AMRF) Ruth Spencer Medical Research Fellowship.
Tarik Sammour, B.H.B., M.B.Ch.B.
- Department of Surgery, South Auckland Clinical School, University of Auckland, Auckland, New Zealand
- Recipient of the Royal Australasian College of Surgeons (RACS) Surgeon Scientist Scholarship.
Tzu-Chieh Yu, B.H.B., M.B.Ch.B.
- Department of Surgery, South Auckland Clinical School, University of Auckland, Auckland, New Zealand
Saleh M. Abbas, M.B.B.S., F.R.A.C.S.
- Department of Surgery, Middlemore Hospital, University of Auckland, Auckland, New Zealand
Andrew G. Hill, M.D., F.R.A.C.S.
- Department of Surgery, South Auckland Clinical School, University of Auckland, Auckland, New Zealand
- To whom correspondence and reprint requests should be addressed at Department of Surgery, Middlemore Hospital, University of Auckland, P.O. Box 93311 Otahuhu, Auckland, New Zealand.

Received 14 December 2009 published online 22 March 2010.

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).