Statin Use and Risk of Delirium in the Critically Ill.
Am J Respir Crit Care Med. 2014 Jan 13;
Authors: Page VJ, Davis D, Zhao XB, Norton S, Casarin A, Brown T, Ely EW, McAuley DF
Rationale Delirium is common in intensive care unit (ICU) patients and is a predictor of worse outcomes and neuroinflammation is a possible mechanism. The anti-inflammatory actions of statins may reduce delirium. Objectives To determine whether critically ill patients receiving statin therapy had a reduced risk of delirium than those not on statins. Methods A prospective cohort analysis of data from consecutive ICU patients admitted to a UK mixed medical and surgical critical care unit between August 2011 and February 2012; the Confusion Assessment Method for ICU (CAM-ICU) was used to determine the days each patient was assessed as being free of delirium during ICU admission. Measurements Delirium free days, daily administration of statins and serum C-reactive protein (CRP) were recorded. Main results Four hundred and seventy consecutive critical care patients were followed from August 2011 to February 2012 of whom 151 patients received statins. Using random-effects multivariable logistic regression, statin administration the previous evening was associated with the patient being assessed as free of delirium (OR = 2.28, (CI 1.01 to 5.13) p < 0.05) and with lower CRP (β = -0.52, p <0.01) the following day. When the association between statin and being assessed as free of delirium was controlled for CRP, the effect size became non-significant (OR = 1.56, (CI 0.64 to 3.79) p=0.32). Conclusions Ongoing statin therapy is associated with a lower daily risk of delirium in critically ill patients. An ongoing clinical trial, informed by this study, is investigating if statins are a potential therapy for delirium in the critically ill.
PMID: 24417431 [PubMed - as supplied by publisher]