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Reducing delirium in seniors


A new study from Ontario’s Institute for Clinical Evaluative Sciences (ICES) found the use of statins—which include Crestor, Lipitor, Pravachol and Zocor was associated with 28% increase risk of post operative delirium among elderly patients.

“Delirium may sometimes be severe, prolonged and stops the patient from thinking straight,” says lead investigator and senior ICES scientist, Dr. Donald Redelmeier. “Even a minor case is stressful to the patient and can interfere with recovering from surgery. Our results found cholesterol-lowering statins may be partially responsible. The study also gives hope because this medication is easy to interrupt before elective surgery.” The ICES research looked at more than 280,000 Ontario elderly patients who underwent elective surgery and received two or more prescriptions for statins in the year before surgery (including at least one prescription in the 90 days preceding surgery). Many patients underwent abdominal, musculoskeletal or urogenital surgery which averaged about two hours. The study published in the September issue of The Canadian Medical Association Journal has the following results:

  • Among the 7% of patients taking statins, 3,195 experienced delirium after surgery.
  • The rate was significantly higher among patients taking statins at 14 per 1,000 than among those not taking the medications, 11 per 1,000.
  • The risk appeared accentuated for non-cardiac operations, extended to more complicated cases of delirium.
  • The link between statins and risk of delirium was not seen for other cholesterol lowering medications, heart disease drugs or other medications.

“Delirium or confusion not only causes anxiety for patients and families, it also contributes to longer hospital stays, more intensive care, extra cat-scans and other tests and further delays,” notes Redelmeier. “Statins are such a common medication that may result in serious complication. Restarting statins after surgery could protect the heart without the risk of delirium.”

ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy.


Read the Journal Article