STATIN therapy in the intensive care unit was associated with a substantially lower risk of 30-day all-cause mortality among patients with non-traumatic intracerebral haemorrhage complicated by acute kidney injury, according to a large observational analysis of US critical care data.
Acute kidney injury (AKI) is a common and prognostically important complication following intracerebral haemorrhage (ICH), particularly in critically ill patients. While statins are widely prescribed for cardiovascular prevention, their potential pleiotropic effects – including anti-inflammatory and endothelial-stabilising actions – have prompted interest in their role during acute illness. Until now, evidence in ICH-AKI has been limited.
Statin Therapy Examined in Real-World ICU Practice
Researchers analysed data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, identifying 1,805 adults admitted to ICU with both non-traumatic ICH and AKI. Patients were grouped according to whether they received statin therapy after ICU admission; 654 patients received statins.
As expected in a real-world cohort, statin users differed from non-users at baseline. They were older, more likely to be male, and had differing clinical characteristics that could influence outcomes. To address this, the investigators applied propensity score matching and inverse probability of treatment weighting to balance demographic and clinical variables between groups.
Lower 30-Day Mortality with Statin Therapy
Across adjusted analyses, statin therapy was consistently associated with improved survival. Kaplan–Meier curves showed a significant separation in 30-day mortality between statin users and non-users (p<0.0001). In a multivariate Cox proportional hazards model, statin therapy was associated with a 52% relative reduction in the risk of death at 30 days (hazard ratio 0.48; 95% CI 0.37–0.62, P < 0.001).
Subgroup analyses broadly supported this association across patient categories, suggesting the finding was not driven by a single demographic or clinical subgroup.
Clinical Relevance for ICH-AKI Management
For clinicians managing ICH complicated by AKI in the ICU, these findings raise important questions about the potential role of statin therapy beyond lipid lowering. Possible mechanisms include modulation of systemic inflammation, improvement in endothelial function, and renal protection, all of which may be relevant in critically ill neurological patients.
The study provides reassurance that continuing or initiating statins in selected ICU patients with ICH-AKI may be associated with better short-term survival, supporting thoughtful, individualised clinical decision-making.
Reference
Chen K et al. Correlation between statin use and 30-day mortality in patients with acute kidney injury after intracerebral hemorrhage: a retrospective analysis. Scientific Reports. 2026;DOI: https://doi.org/10.1038/s41598-025-34820-8.
