title: Role of statins in delirium prevention in critical ill and cardiac surgery patients: A systematic review and meta-analysis.
abstract: The data evaluating the role of statins in delirium prevention in the intensive care unit are conflicting and limited.
  
  
  
  We 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.
  
  
  
  Of 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).
  
  
  
  In critically ill and cardiac surgery patients, this meta-analysis did not show a benefit with statin therapy in the prevention of delirium.
authors: 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.
authors: Saraschandra
authors: S
authors: Vallabhajosyula
authors: Division of Cardiovascular Diseases, Department of Internal Medicine, Creighton University School of Medicine, Omaha, NE.
authors: Arun
authors: A
authors: Kanmanthareddy
authors: Mayo Clinic Libraries, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, MN; Evidence-Based Practice Research Program, Mayo Clinic, Rochester, MN.
authors: Patricia J
authors: PJ
authors: Erwin
authors: Division of Cardiovascular Diseases, Department of Internal Medicine, Creighton University School of Medicine, Omaha, NE.
authors: Dennis J
authors: DJ
authors: Esterbrooks
authors: Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Creighton University School of Medicine, Omaha, NE; Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha, NE.
authors: Lee E
authors: LE
authors: Morrow
mesh_terms: D006348:Cardiac Surgical Procedures; D016638:Critical Illness; D003693:Delirium / Q000517:prevention & control*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007362:Intensive Care Units; D011183:Postoperative Complications / Q000517:prevention & control*
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Cardiac surgery; Critical care; Delirium; Meta-analysis; Statins