Statin Use and Delirium Risk: An Updated Systematic Review and Meta-Analysis

Purpose: Findings on the association of statin use with delirium risk are inconsistent. We performed an up-to-date systematic review and meta-analysis to elucidate this association among critically ill and surgical patients. Materials and Methods: We searched PubMed, the Cochrane Library, and the EMBASE database, limiting the search to human patients and articles in English published until December 31, 2021. The odds ratio (OR) and 95% confidence interval (CI) were used to indicate the difference in the incidence of delirium between statin use and nonuse groups. A random-effects model was selected in the case of high heterogeneity of study populations. We used funnel plots, Egger’s test, Duval and Tweedie’s trim-and-fill approach, and the classic fail-safe N to assess publication bias. Findings: Of a total of 264 identified studies, 13 were selected for the qualitative review—4 RCTs and 9 observational cohort studies. Statin use was not associated with low delirium risk (pooled OR, 0·82; 95% CI, 0·64 to 1·04; p = 0·09). Substantial statistical heterogeneity was observed (I2, 90%). Visual inspection of the funnel plot of ORs from the studies revealed symmetry. Conclusions: Statin use is not associated with delirium risk. More comprehensive RCTs are required to confirm the results.