Role of statins in delirium prevention in critical ill and cardiac surgery patients

A systematic review and meta-analysis

Saraschandra Vallabhajosyula, Arun Kanmanthareddy, Patricia J. Erwin, Dennis J. Esterbrooks, Lee E. Morrow

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background The data evaluating the role of statins in delirium prevention in the intensive care unit are conflicting and limited. Methods We performed a systematic review and meta-analysis of literature from 1975 to 2015. All English-language adult studies evaluating delirium incidence in statin and statin nonusers were included and studies without a control group were excluded. Mantel-Haenszel model was used to calculate pooled risk ratios (RRs) and 95% confidence intervals (CIs). Statistical significance was defined as CI not including unity and P value less than.05. Results Of a total 57 identified studies, 6 were included. The studies showed high heterogeneity (I2 = 73%) for all and moderate for cardiac surgery studies (I2 = 55%). Of 289 773 patients, statins were used in 22 292 (7.7%). Cardiac surgery was performed in 4382 (1.5%) patients and 2321 (53.0%) used statins. Delirium was noted in 710 (3.2%) and 3478 (1.3%) of the patients in the statin and nonstatin groups, respectively, with no difference between groups in the total cohort (RR, 1.05 [95% CI, 0.85-1.29]; P =.56) or in cardiac surgery patients (RR, 1.03 [95% CI, 0.68-1.56]; P =.89). Conclusions In critically ill and cardiac surgery patients, this meta-analysis did not show a benefit with statin therapy in the prevention of delirium.

Original languageEnglish (US)
Pages (from-to)189-196
Number of pages8
JournalJournal of Critical Care
Volume37
DOIs
StatePublished - Feb 1 2017

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Delirium
Thoracic Surgery
Meta-Analysis
Confidence Intervals
Odds Ratio
Critical Illness
Intensive Care Units
Language
Control Groups
Incidence

All Science Journal Classification (ASJC) codes

  • Critical Care and Intensive Care Medicine

Cite this

Role of statins in delirium prevention in critical ill and cardiac surgery patients : A systematic review and meta-analysis. / Vallabhajosyula, Saraschandra; Kanmanthareddy, Arun; Erwin, Patricia J.; Esterbrooks, Dennis J.; Morrow, Lee E.

In: Journal of Critical Care, Vol. 37, 01.02.2017, p. 189-196.

Research output: Contribution to journalArticle

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abstract = "Background The data evaluating the role of statins in delirium prevention in the intensive care unit are conflicting and limited. Methods We performed a systematic review and meta-analysis of literature from 1975 to 2015. All English-language adult studies evaluating delirium incidence in statin and statin nonusers were included and studies without a control group were excluded. Mantel-Haenszel model was used to calculate pooled risk ratios (RRs) and 95{\%} confidence intervals (CIs). Statistical significance was defined as CI not including unity and P value less than.05. Results Of a total 57 identified studies, 6 were included. The studies showed high heterogeneity (I2 = 73{\%}) for all and moderate for cardiac surgery studies (I2 = 55{\%}). Of 289 773 patients, statins were used in 22 292 (7.7{\%}). Cardiac surgery was performed in 4382 (1.5{\%}) patients and 2321 (53.0{\%}) used statins. Delirium was noted in 710 (3.2{\%}) and 3478 (1.3{\%}) of the patients in the statin and nonstatin groups, respectively, with no difference between groups in the total cohort (RR, 1.05 [95{\%} CI, 0.85-1.29]; P =.56) or in cardiac surgery patients (RR, 1.03 [95{\%} CI, 0.68-1.56]; P =.89). Conclusions In critically ill and cardiac surgery patients, this meta-analysis did not show a benefit with statin therapy in the prevention of delirium.",
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N2 - Background The data evaluating the role of statins in delirium prevention in the intensive care unit are conflicting and limited. Methods We performed a systematic review and meta-analysis of literature from 1975 to 2015. All English-language adult studies evaluating delirium incidence in statin and statin nonusers were included and studies without a control group were excluded. Mantel-Haenszel model was used to calculate pooled risk ratios (RRs) and 95% confidence intervals (CIs). Statistical significance was defined as CI not including unity and P value less than.05. Results Of a total 57 identified studies, 6 were included. The studies showed high heterogeneity (I2 = 73%) for all and moderate for cardiac surgery studies (I2 = 55%). Of 289 773 patients, statins were used in 22 292 (7.7%). Cardiac surgery was performed in 4382 (1.5%) patients and 2321 (53.0%) used statins. Delirium was noted in 710 (3.2%) and 3478 (1.3%) of the patients in the statin and nonstatin groups, respectively, with no difference between groups in the total cohort (RR, 1.05 [95% CI, 0.85-1.29]; P =.56) or in cardiac surgery patients (RR, 1.03 [95% CI, 0.68-1.56]; P =.89). Conclusions In critically ill and cardiac surgery patients, this meta-analysis did not show a benefit with statin therapy in the prevention of delirium.

AB - Background The data evaluating the role of statins in delirium prevention in the intensive care unit are conflicting and limited. Methods We performed a systematic review and meta-analysis of literature from 1975 to 2015. All English-language adult studies evaluating delirium incidence in statin and statin nonusers were included and studies without a control group were excluded. Mantel-Haenszel model was used to calculate pooled risk ratios (RRs) and 95% confidence intervals (CIs). Statistical significance was defined as CI not including unity and P value less than.05. Results Of a total 57 identified studies, 6 were included. The studies showed high heterogeneity (I2 = 73%) for all and moderate for cardiac surgery studies (I2 = 55%). Of 289 773 patients, statins were used in 22 292 (7.7%). Cardiac surgery was performed in 4382 (1.5%) patients and 2321 (53.0%) used statins. Delirium was noted in 710 (3.2%) and 3478 (1.3%) of the patients in the statin and nonstatin groups, respectively, with no difference between groups in the total cohort (RR, 1.05 [95% CI, 0.85-1.29]; P =.56) or in cardiac surgery patients (RR, 1.03 [95% CI, 0.68-1.56]; P =.89). Conclusions In critically ill and cardiac surgery patients, this meta-analysis did not show a benefit with statin therapy in the prevention of delirium.

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