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

Abstract

Background: Findings on the association of statin use with delirium risk are inconsistent. The Study Question: Is statin use associated with delirium risk? Study Design: 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 effect size and 95% confidence interval (CI) were defined as the odds ratio (OR) and 95% CI, respectively, 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 test, Duval and Tweedie trim-and-fill approach, and the classic fail-safe N to assess publication bias. Results: 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, 0·64–1·04; P = 0·09). Substantial statistical heterogeneity was observed (I 2, 90%). Visual inspection of the funnel plot of ORs from the studies revealed symmetry. Using the Grading of Recommendations Assessment, Development, and Evaluation approach, we assigned the evidence a rating of C and a weak recommendation for this review. Conclusions: Statin use is not associated with delirium risk. More comprehensive RCTs are required to confirm the results.