Association Between Statin Use in the Intensive Care Unit and Delirium in Patients Receiving Mechanical Ventilation: A Cross-Sectional Study

Background and Aims

Delirium is a temporary cognitive dysfunction caused by organic factors. It is characterized by impaired attention and cognitive abilities. This condition is associated with a high prevalence of misdiagnosis and considerable risks of disability and mortality, particularly in intensive care unit (ICU) patients undergoing mechanical ventilation (MV). This study aimed to investigate the impact of the use of statins on the occurrence of delirium in patients undergoing MV in the ICU by applying a comprehensive data set.

Methods

The Medical Information Mart for Intensive Care-IV (MIMIC-IV) database was used for participant recruitment. The primary outcome was the prevalence of delirium. Secondary outcomes were the duration of ICU stay (DoIS) and duration of hospital stay (DoHS). Multivariable logistic regression and multivariate linear regression were employed to carry out statistical analyses. Propensity-score matching (PSM) was utilized to enhance the robustness of findings. Statin use was determined based on patients' medication history before ICU admission. All the examinations and tests were conducted within 24 h after patients were admitted to the ICU.

Results

The study comprised 18,146 participants with a mean age of 63.4 years and the prevalence of delirium was 7.6% (1381/18,146). According to multivariable logistic regression models, patients prescribed statins exhibited a 15% higher prevalence of delirium (odds ratio = 1.15, 95% confidence interval = 1.01–1.37, p < 0.05). Statin administration in the ICU correlated with a 4.03-h decrease in ventilation time (p < 0.001). These results suggest that statin use may increase the risk of delirium in patients undergoing MV, even following stratification of statin use and PSM. Statins did not have a significant impact on DoIS, however, their use was associated with a longer DoHS.

Conclusion

The findings of this retrospective cross-sectional study indicate that statin use is linked to an increased risk of delirium in patients receiving MV in the ICU.