他汀类药物对危重患者脓毒症相关性谵妄的影响：基于MIMIC-IV数据库的回顾性队列研究

打开文本图片集

【中图分类号】 R972+.6 【文献标识码】A

【Abstract】 Objective To explore the impact of statins on the risk of sepsis-associated delirium （SAD） in critically il patients. Methods This retrospective cohort study analyzed data of adult intensive care unit （ICU） patients from the MIMIC-IV database who met the inclusion criteria.The association between before ICU admission （pre-ICU） statin use and the incidence of SAD was examined byunivariate and multivariable Logistic regresson analysis，propensity score matching （PSM），inverse probability weighting （IPW），and subgroup analysis employing propensity score matching and inverse probability weighting to adjust for potential confounders. The adjusted odds ratio （OR） with 95% CI was calculated in corresponding cohorts.Results A total of 6，649 critically ill patients were included in the analysis，among whom 35.1% developed SAD.Patients with pre-ICU statin use showed a lower incidence of SAD compared to those without （ 27.6% Vs. 38.0% in origin cohort， 27.2% Vs. 33.9% in the PSM cohort）.Pre-ICU statin use showed a stable protective effect against SAD across different analyses： in original cohort [OR ：=0.562 ， 95%CI （0.491， 0.642）， P<0.001Ω 1， thePSMcohort[OH λ=0.707 ， 95%CI （0.630， 0.794）， P<0.001 ]and the IPW cohort OR=0.627 ， （204号 95%CI （0.573， 0.686）， P<0.001 ]. Subgroup analyses indicated that the protective effects of statins were more pronounced in the population aged （ ≥65 years）[OR =0.622 ， 95%CI （0.525， 0.736）， P<0.001 ]，and that lipophilic statins demonstrated a significant protective effect against SAD [OR -0.527 ， 95%CI （0.454，0.609）， P<0.001 」 E -value analysis indicated that this association was robust to unmeasured confounding factors. Conclusion Pre-ICU statin use is associated with a reduced incidence ofSAD，particularly among elderly patients and those receiving lipophilic statins.These findings support the potential role ofstatins administration in the management ofdelirium in septic patients and underscore the importance of maintaining statin therapy during critical illness. Future prospective studies are needed to confirm these results and guide clinical practice.

【Keywords】Statin; Sepsis; Delirium; Critical care; MIMIC-IV database

脓毒症是机体对感染的反应失调所致的危及生命的器官功能障碍。（剩余14533字）