The Relationship between Delirium and Statin Use According to Disease Severity in Patients in the Intensive Care Unit

Association between statin use on delirium and 30-day mortality in patients with chronic obstructive pulmonary disease in the intensive care unit

BACKGROUND

Delirium occurs frequently in patients with chronic obstructive pulmonary disease in the intensive care unit. Effective prevention and treatment strategies for delirium remain limited. We aimed to assess delirium and 30-day mortality in patients with chronic obstructive pulmonary disease who were statin and non-statin users.

METHODS

In this retrospective study, patients with chronic obstructive pulmonary disease were identified from the Medical Information Mart for Intensive Care database (MIMIC-IV). The primary exposure variable was the use of statins 3 days after entering the intensive care unit and the primary outcome measure was the presence of delirium. The secondary outcome measure was 30-day mortality. Since the cohort study was retrospective, we used an inverse probability weighting derived from the propensity score matching to balance different variables.

RESULTS

Among a cohort of 2725 patients, 1484 (54.5%) were statin users. Before propensity score matching, the prevalence of delirium was 16% and the 30-day mortality was 18% in patients with chronic obstructive pulmonary disease. Statin use was significantly negatively correlated with delirium, with an odds ratio of 0.69 (95% CI 0.56-0.85, p < 0.001) in the inverse probability weighted cohort and 30-day mortality of 0.7 (95% CI 0.57-0.85, p < 0.001).

CONCLUSIONS

Statin use is associated with a lower incidence of delirium and 30-day mortality in patients with chronic obstructive pulmonary disease in the intensive care unit.

Association between delirium and statin use in patients with congestive heart failure: a retrospective propensity score-weighted analysis

Background

The relationship between statin use and delirium remains controversial; therefore, we aimed to study the association between statin exposure and delirium and in-hospital mortality in patients with congestive heart failure.

Methods

In this retrospective study, patients with congestive heart failure were identified from the Medical Information Mart for Intensive Care database. The primary exposure variable was statin use 3 days after admission to the intensive care unit, and the primary outcome measure was the presence of delirium. The secondary outcome measure was in-hospital mortality. Since the cohort study was retrospective, we used inverse probability weighting derived from the propensity score to balance various variables.

Results

Of 8,396 patients, 5,446 (65%) were statin users. Before matching, the prevalence of delirium was 12.5% and that of in-hospital mortality was 11.8% in patients with congestive heart failure. Statin use was significantly negatively correlated with delirium, with an odds ratio of 0.76 (95% confidence interval: [0.66-0.87]; P < 0.001) in the inverse probability weighting cohort and in-hospital mortality of 0.66 (95% confidence interval: [0.58-0.75]; P < 0.001).

Conclusion

Statins administered in the intensive care unit can significantly reduce the incidence of delirium and in-hospital mortality in patients with congestive heart failure.