Correlation between statin use and 30 day mortality in patients with acute kidney injury after intracerebral hemorrhage: a retrospective analysis

Acute kidney injury (AKI) is a frequent complication in patients with nontraumatic intracerebral hemorrhage (ICH). Previous studies have suggested that statins may improve survival in patients with AKI. This study investigated the association between statin therapy and 30 day all-cause mortality in patients with ICH. Patients with both nontraumatic intracerebral hemorrhage and acute kidney injury (ICH-AKI) were identified from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. After intensive care unit (ICU) admission, patients were categorized into statin and non-statin groups based on their statin use. To assess the effect of statin therapy on 30-day mortality, we first accounted for baseline differences using both propensity score matching (PSM) and inverse probability of treatment weighting (IPTW). Then, we performed multivariate regression and subgroup analyses on the balanced cohorts. Among 1805 patients with ICH-AKI, 654 received statin therapy. Compared with those who did not receive statins, statin users were older, had a higher proportion of males, and exhibited a lower 30 day mortality rate. After adjustment for demographic and clinical covariates, a significant survival benefit was observed in the statin group via Kaplan-Meier analysis (p < 0.0001). This finding was robustly confirmed by a multivariate Cox model [hazard ratio (HR) = 0.48; 95% confidence interval (CI): 0.37-0.62; P < 0.001]. Consistent with this, subgroup analyses affirmed the protective association of statin use in ICH-AKI patients. Statin therapy in the ICU was associated with reduced 30 day all-cause mortality in patients with ICH-AKI.