Role of statins in delirium prevention in critical ill and cardiac surgery patients: A systematic review and meta-analysis

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• 作者：Saraschandra Vallabhajosyula ; MBBS^a ; ^b ; ^{Vallabhajosyula.Saraschandra@mayo.edu} ; Arun Kanmanthareddy ; MD ; MS^c ; Patricia J. Erwin ; MLS^d ; ^e ; Dennis J. Esterbrooks ; MD ; FACC^c ; Lee E. Morrow ; MD ; MSc ; FACP ; FCCP^f ; ^g
• 关键词：Statins ; Delirium ; Critical care ; Cardiac surgery ; Meta-analysis
• 刊名：Journal of Critical Care
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：37
• 期：Complete
• 页码：189-196
• 全文大小：752 K
• 卷排序：37

文摘

The data evaluating the role of statins in delirium prevention in the intensive care unit are conflicting and limited.MethodsWe 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.ResultsOf 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).ConclusionsIn critically ill and cardiac surgery patients, this meta-analysis did not show a benefit with statin therapy in the prevention of delirium.