Statin Use and Risk of Delirium in the Critically Ill

Valerie J. Page, Daniel Davis, Xiao B. Zhao, Samuel Norton, Annalisa Casarin, Thomas Brown, E. Wesley Ely, Daniel F. McAuley

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Rationale: Delirium is common in intensive care unit (ICU) patients and is a predictor of worse outcomes and neuroinflammation is a possible mechanism. The antiinflammatory 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 was used to determine the days each patient was assessed as being free of delirium during ICU admission.

Measurements and Main Results: Delirium-free days, daily administration of statins, and serum C-reactive protein (CRP) were recorded. Four hundred and seventy consecutive critical care patients were followed, of whom 151 patients received statins. Using randomeffects multivariable logistic regression, statin administration the previous evening was associated with the patient being assessed as free of delirium (odds ratio, 2.28; confidence interval, 1.01-5.13; P , 0.05) and with lower CRP (b = 20.52; 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 nonsignificant (odds ratio, 1.56; confidence interval, 0.64-3.79; 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.
Original languageEnglish
Pages (from-to)666-673
Number of pages8
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume189
Issue number6
Early online date13 Jan 2014
DOIs
Publication statusPublished - 15 Mar 2014

Keywords

  • C-Reactive Protein
  • Critical care
  • delirium
  • inflammation
  • statin

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