• Saraschandra Vallabhajosyula, Arun Kanmanthareddy, Patricia J Erwin, Dennis J Esterbrooks, and Lee E Morrow.
• Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN; Multidisciplinary Epidemiology and Translational Research in Intensive Care (METRIC) Laboratory, Mayo Clinic, Rochester, MN. Electronic address: Vallabhajosyula.Saraschandra@mayo.edu.
• J Crit Care. 2017 Feb 1; 37: 189-196.

BackgroundThe 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.Copyright © 2016 Elsevier Inc. All rights reserved.

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