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Staying on statins might stave off delirium in ICU patients

Tuesday January 21, 2014
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Continued use of statins may help prevent delirium in critically ill patients who received statins before hospital admission, according to a British study.

“This is the first study using a validated delirium screening tool, the Confusion Assessment Method-ICU, to show that the administration of statins reduces delirium in these patients,” the study’s lead author, Valerie J. Page, MB, ChB, of Watford General Hospital in the United Kingdom, said in a news release. “This benefit may be mediated by a reduction in systemic inflammation.”

The study, published this month on the website of the American Journal of Respiratory and Critical Care Medicine, included 470 patients, 151 of whom received statins. Patients were administered statins only if they had received them prior to admission.

After adjustment for age, sex and illness severity, administration of statins the previous evening was associated with a significantly lower risk of delirium and a concomitant reduction in serum C-reactive protein, a marker of systemic inflammation, the following day. The strength of the relationship between statin use and a lower risk of delirium was reduced when the researchers adjusted for CRP.

“Although the pathogenesis of delirium is not fully understood, these data are consistent with a neuro-inflammatory cause and suggest that the anti-inflammatory effects of statins may contribute to the effects of statin treatment on delirium,” Page said. “Our study on statin use and the risk of delirium in critically ill subjects included extensive data on a large, broadly representative population of consecutive intensive care patients, increasing its strength.”

Study limitations include the possibility that not all potential confounding factors were adjusted for and the limits of cognitive assessment tools in critically ill patients, the researchers said.

“Our findings suggest that statin treatment should be continued to help prevent delirium in critically ill patients who received statins before being admitted,” Page said. “The relationship between statin therapy and delirium and the mechanisms underlying this relationship are the subject of an ongoing randomized, placebo-controlled study in critically ill ventilated patients.”

The American Journal of Respiratory and Critical Care Medicine is a publication of the American Thoracic Society. Study abstract: www.atsjournals.org/doi/abs/10.1164/rccm.201306-1150OC#.UtlttbTnapo


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