Association Between Statin Use on Delirium and 30-day Mortality in Patients with Chronic Obstructive Pulmonary Disease

Abstract

Background: Delirium occurs frequently in patients with chronic obstructive pulmonary disease(COPD) in the intensive care unit(ICU).Effective prevention and treatment strategies for delirium remain limited. We aimed to assess delirium and 30-day mortality in patients with COPD who were statin and non-statin users. Methods: In this retrospective study,patients with COPD 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 ICU 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 2738 patients, 1493 (55%) were statin users. Before propensity score matching, the prevalence of delirium was 16% and the 30-day mortality was 18% in patients with COPD. Statin use was significantly negatively correlated with delirium, with an odds ratio of 0.69 (95% CI,0.56~0.84, P < 0.001) in the inverse probability weighted cohort and 30-day mortality of 0.7 (95% CI,0.58~0.85, P < 0.001). Conclusions: Statins administered in the ICU can significantly reduce the incidence of delirium and 30-day mortality in patients with COPD.