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        Statin use and risk of delirium in the critically Ill

        Author
        Page, V J
        Davis, D
        Zhao, X B
        Norton, Sam
        Casarin, Annalisa
        Brown, T
        Ely, E.W
        McAuley, D F
        Attention
        2299/20657
        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 random-effects 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 (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 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.
        Publication date
        2014-03-15
        Published in
        American Journal of Respiratory and Critical Care Medicine
        Published version
        https://doi.org/10.1164/rccm.201306-1150OC
        Other links
        http://hdl.handle.net/2299/20657
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