Evidence map›Paper›PMID 36104793›Full record

ArticlePerioperative medicine (London, England)2022

Perioperative statin medication impairs pulmonary outcome after abdomino-thoracic esophagectomy.

Martin Reichert, Maike Lang, Joern Pons-Kühnemann, Michael Sander, Winfried Padberg, Andreas Hecker

Open access · goldAbstract read
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Article in Perioperative medicine (London, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Martin ReichertDepartment of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Rudolf-Buchheim-Strasse 7, 35390, Giessen, Germany. martin.reichert@chiru.med.uni-giessen.de.
Maike LangDepartment of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Rudolf-Buchheim-Strasse 7, 35390, Giessen, Germany.
Joern Pons-KühnemannMedical Statistics, Institute of Medical Informatics, Justus-Liebig-University of Giessen, Rudolf-Buchheim-Strasse 6, 35390, Giessen, Germany.
Michael SanderDepartment of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital of Giessen, Rudolf-Buchheim-Strasse 7, 35390, Giessen, Germany.
Winfried PadbergDepartment of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Rudolf-Buchheim-Strasse 7, 35390, Giessen, Germany.
Andreas HeckerDepartment of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Rudolf-Buchheim-Strasse 7, 35390, Giessen, Germany.
Universitätsklinikum Gießen und Marburg · DEUniversity of Giessen · DE

Funding

Justus-Liebig University Giessen Clinician Scientist Program in Biomedical Research (JLU-CAREER) funded by the German Research Foundation DFG No. GU405/14-1
6 · The paper itself

Abstract

backgroundAlthough surgery is the curative option of choice for patients with locally advanced esophageal cancer, morbidity, especially the rate of pulmonary complications, and consequently mortality of patients undergoing abdomino-thoracic esophagectomy remain unacceptably high. Causes for developing post-esophagectomy pulmonary complications are trauma to the lung and thoracic cavity as well as systemic inflammatory response. Statins are known to influence inflammatory pathways, but whether perioperative statin medication impacts on inflammatory response and pulmonary complication development after esophagectomy had not been investigated, yet.

methodsRetrospective analysis and propensity score matching of patients, who either received perioperative statin medication [statin( +)] or not [statin( -)], with regard to respiratory impairment (PaO

resultsSeventy-eight patients who underwent abdomino-thoracic esophagectomy for cancer were included into propensity score pair-matched analysis [statin( +): n = 26 and statin( -): n = 52]. Although no differences were seen in postoperative inflammatory serum markers, C-reactive protein values correlated significantly with the development of pneumonia beyond postoperative day 3 in statin( -) patients. This effect was attenuated under statin medication. No difference was seen in cumulative incidences of respiratory impairment; however, significantly higher rate (65.4% versus 38.5%, p = 0.0317, OR 3.022, 95% CI 1.165-7.892) and higher cumulative incidence (p = 0.0468) of postoperative pneumonia were seen in statin( +) patients, resulting in slightly longer postoperative stay on intensive care unit (p = 0.0612) as well as significantly prolonged postoperative in-hospital stay (p = 0.0185).

conclusionsDevelopment of pulmonary complications after abdomino-thoracic esophagectomy is multifactorial but frequent. The establishment of preventive measures into the perioperative clinical routine is mandatory for an improved patient outcome. Perioperative medication with statins might influence pneumonia development in the highly vulnerable lung after abdomino-thoracic esophagectomy. Perioperative interruption of statin medication might be beneficial in appropriate patients; however, further clinical trials and translational studies are needed to prove this hypothesis.

Indexed as

Esophageal cancerEsophagectomyIvor LewisPerioperative medicationPneumoniaStatin

Identifiers

PMID36104793
PMCPMC9472330
OpenAlexW4295665327

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