TY - JOUR
T1 - Role of statins in delirium prevention in critical ill and cardiac surgery patients
T2 - A systematic review and meta-analysis
AU - Vallabhajosyula, Saraschandra
AU - Kanmanthareddy, Arun
AU - Erwin, Patricia J.
AU - Esterbrooks, Dennis J.
AU - Morrow, Lee E.
N1 - Funding Information:
CTSA Grant No. UL1 TR000135 from the National Center for Advancing Translational Sciences, a component of the National Institutes of Health, Bethesda MD
Publisher Copyright:
© 2016 Elsevier Inc.
PY - 2017/2/1
Y1 - 2017/2/1
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.
UR - http://www.scopus.com/inward/record.url?scp=85006275104&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85006275104&partnerID=8YFLogxK
U2 - 10.1016/j.jcrc.2016.09.025
DO - 10.1016/j.jcrc.2016.09.025
M3 - Article
C2 - 27776336
AN - SCOPUS:85006275104
SN - 0883-9441
VL - 37
SP - 189
EP - 196
JO - Seminars in Anesthesia
JF - Seminars in Anesthesia
ER -