Skip to main content
Top
Published in: European Journal of Medical Research 1/2023

Open Access 01-12-2023 | Statins | Research

Association between statin use on delirium and 30-day mortality in patients with chronic obstructive pulmonary disease in the intensive care unit

Authors: Jiangling Xia, Chunhuan Hu, Leilei Wang, Yuzhu Zhang

Published in: European Journal of Medical Research | Issue 1/2023

Login to get access

Abstract

Background

Delirium occurs frequently in patients with chronic obstructive pulmonary disease in the intensive care unit. Effective prevention and treatment strategies for delirium remain limited. We aimed to assess delirium and 30-day mortality in patients with chronic obstructive pulmonary disease who were statin and non-statin users.

Methods

In this retrospective study, patients with chronic obstructive pulmonary disease were identified from the Medical Information Mart for Intensive Care database (MIMIC-IV). The primary exposure variable was the use of statins 3 days after entering the intensive care unit and the primary outcome measure was the presence of delirium. The secondary outcome measure was 30-day mortality. Since the cohort study was retrospective, we used an inverse probability weighting derived from the propensity score matching to balance different variables.

Results

Among a cohort of 2725 patients, 1484 (54.5%) were statin users. Before propensity score matching, the prevalence of delirium was 16% and the 30-day mortality was 18% in patients with chronic obstructive pulmonary disease. Statin use was significantly negatively correlated with delirium, with an odds ratio of 0.69 (95% CI 0.56–0.85, p < 0.001) in the inverse probability weighted cohort and 30-day mortality of 0.7 (95% CI 0.57–0.85, p < 0.001).

Conclusions

Statin use is associated with a lower incidence of delirium and 30-day mortality in patients with chronic obstructive pulmonary disease in the intensive care unit.
Appendix
Available only for authorised users
Literature
1.
3.
go back to reference Fu X, et al. Delirium in elderly patients with COPD combined with respiratory failure undergoing mechanical ventilation: a prospective cohort study. BMC Pulm Med. 2022;22(1):266.CrossRefPubMedPubMedCentral Fu X, et al. Delirium in elderly patients with COPD combined with respiratory failure undergoing mechanical ventilation: a prospective cohort study. BMC Pulm Med. 2022;22(1):266.CrossRefPubMedPubMedCentral
4.
go back to reference Szylińska A, et al. Postoperative delirium in patients with chronic obstructive pulmonary disease after coronary artery bypass grafting. Medicina. 2020;56(7):342.CrossRefPubMedPubMedCentral Szylińska A, et al. Postoperative delirium in patients with chronic obstructive pulmonary disease after coronary artery bypass grafting. Medicina. 2020;56(7):342.CrossRefPubMedPubMedCentral
6.
go back to reference Witlox J, et al. Delirium in elderly patients and the risk of postdischarge mortality, institutionalization, and dementia: a meta-analysis. JAMA. 2010;304(4):443–51.CrossRefPubMed Witlox J, et al. Delirium in elderly patients and the risk of postdischarge mortality, institutionalization, and dementia: a meta-analysis. JAMA. 2010;304(4):443–51.CrossRefPubMed
7.
go back to reference Mather JF, et al. Statin and its association with delirium in the medical ICU. Crit Care Med. 2017;45(9):1515–22.CrossRefPubMed Mather JF, et al. Statin and its association with delirium in the medical ICU. Crit Care Med. 2017;45(9):1515–22.CrossRefPubMed
8.
go back to reference Lee DS, et al. Preoperative statins are associated with a reduced risk of postoperative delirium following vascular surgery. PLoS ONE. 2018;13(3):e0192841.CrossRefPubMedPubMedCentral Lee DS, et al. Preoperative statins are associated with a reduced risk of postoperative delirium following vascular surgery. PLoS ONE. 2018;13(3):e0192841.CrossRefPubMedPubMedCentral
9.
go back to reference An JY, et al. The relationship between delirium and statin use according to disease severity in patients in the intensive care unit. Clin Psychopharmacol Neurosci. 2023;21(1):179–87.CrossRefPubMedPubMedCentral An JY, et al. The relationship between delirium and statin use according to disease severity in patients in the intensive care unit. Clin Psychopharmacol Neurosci. 2023;21(1):179–87.CrossRefPubMedPubMedCentral
12.
go back to reference Walsh A, et al. Statins versus placebo for people with chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2019;7(7):CD011959.PubMed Walsh A, et al. Statins versus placebo for people with chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2019;7(7):CD011959.PubMed
13.
go back to reference Zhang W, et al. Effect of statins on COPD: a meta-analysis of randomized controlled trials. Chest. 2017;152(6):1159–68.CrossRefPubMed Zhang W, et al. Effect of statins on COPD: a meta-analysis of randomized controlled trials. Chest. 2017;152(6):1159–68.CrossRefPubMed
14.
go back to reference Agusti A, Hogg JC. Update on the pathogenesis of chronic obstructive pulmonary disease. N Engl J Med. 2019;381(13):1248–56.CrossRefPubMed Agusti A, Hogg JC. Update on the pathogenesis of chronic obstructive pulmonary disease. N Engl J Med. 2019;381(13):1248–56.CrossRefPubMed
17.
go back to reference Fan L, et al. Association between serum sodium and long-term mortality in critically ill patients with comorbid chronic obstructive pulmonary disease: analysis from the MIMIC-IV database. Int J Chron Obstruct Pulmon Dis. 2022;17:1143–55.CrossRefPubMedPubMedCentral Fan L, et al. Association between serum sodium and long-term mortality in critically ill patients with comorbid chronic obstructive pulmonary disease: analysis from the MIMIC-IV database. Int J Chron Obstruct Pulmon Dis. 2022;17:1143–55.CrossRefPubMedPubMedCentral
18.
go back to reference Ely EW, et al. Evaluation of delirium in critically ill patients: validation of the confusion assessment method for the intensive care unit (CAM-ICU). Crit Care Med. 2001;29(7):1370–9.CrossRefPubMed Ely EW, et al. Evaluation of delirium in critically ill patients: validation of the confusion assessment method for the intensive care unit (CAM-ICU). Crit Care Med. 2001;29(7):1370–9.CrossRefPubMed
19.
go back to reference Feng M, et al. Transthoracic echocardiography and mortality in sepsis: analysis of the MIMIC-III database. Intensive Care Med. 2018;44(6):884–92.CrossRefPubMed Feng M, et al. Transthoracic echocardiography and mortality in sepsis: analysis of the MIMIC-III database. Intensive Care Med. 2018;44(6):884–92.CrossRefPubMed
20.
21.
go back to reference Xia J, et al. Association between delirium and statin use in patients with congestive heart failure: a retrospective propensity score-weighted analysis. Front Aging Neurosci. 2023;15:1184298.CrossRefPubMedPubMedCentral Xia J, et al. Association between delirium and statin use in patients with congestive heart failure: a retrospective propensity score-weighted analysis. Front Aging Neurosci. 2023;15:1184298.CrossRefPubMedPubMedCentral
22.
go back to reference Bartziokas K, et al. Statins and outcome after hospitalization for COPD exacerbation: a prospective study. Pulm Pharmacol Ther. 2011;24(5):625–31.CrossRefPubMed Bartziokas K, et al. Statins and outcome after hospitalization for COPD exacerbation: a prospective study. Pulm Pharmacol Ther. 2011;24(5):625–31.CrossRefPubMed
23.
go back to reference Lin CM, et al. Statin use and the risk of subsequent hospitalized exacerbations in COPD patients with frequent exacerbations. Int J Chron Obstruct Pulmon Dis. 2020;15:289–99.CrossRefPubMedPubMedCentral Lin CM, et al. Statin use and the risk of subsequent hospitalized exacerbations in COPD patients with frequent exacerbations. Int J Chron Obstruct Pulmon Dis. 2020;15:289–99.CrossRefPubMedPubMedCentral
24.
go back to reference Kim JH, et al. The influence of prior statin use on the prevalence and exacerbation of chronic obstructive pulmonary disease in an adult population. Front Med. 2022;9:842948.CrossRef Kim JH, et al. The influence of prior statin use on the prevalence and exacerbation of chronic obstructive pulmonary disease in an adult population. Front Med. 2022;9:842948.CrossRef
25.
go back to reference Ingebrigtsen TS, et al. Statin use and exacerbations in individuals with chronic obstructive pulmonary disease. Thorax. 2015;70(1):33–40.CrossRefPubMed Ingebrigtsen TS, et al. Statin use and exacerbations in individuals with chronic obstructive pulmonary disease. Thorax. 2015;70(1):33–40.CrossRefPubMed
28.
go back to reference Chen JH, et al. Protective effects of atorvastatin on cerebral vessel autoregulation in an experimental rabbit model of subarachnoid hemorrhage. Mol Med Rep. 2018;17(1):1651–9.PubMed Chen JH, et al. Protective effects of atorvastatin on cerebral vessel autoregulation in an experimental rabbit model of subarachnoid hemorrhage. Mol Med Rep. 2018;17(1):1651–9.PubMed
30.
Metadata
Title
Association between statin use on delirium and 30-day mortality in patients with chronic obstructive pulmonary disease in the intensive care unit
Authors
Jiangling Xia
Chunhuan Hu
Leilei Wang
Yuzhu Zhang
Publication date
01-12-2023
Publisher
BioMed Central
Published in
European Journal of Medical Research / Issue 1/2023
Electronic ISSN: 2047-783X
DOI
https://doi.org/10.1186/s40001-023-01551-3

Other articles of this Issue 1/2023

European Journal of Medical Research 1/2023 Go to the issue