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ORIGINAL RESEARCH article

Front. Neurol.

Sec. Neurocritical and Neurohospitalist Care

Protective effect of statins in patients with sepsis-associated encephalopathy: a retrospective cohort study

  • 1. The First People's Hospital of Chenzhou, Chenzhou, China

  • 2. The Second Xiangya Hospital of Central South University, Changsha, China

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Abstract

Background: Sepsis-associated encephalopathy (SAE) is a severe neurological complication of sepsis. Statins may exerted protective effects in sepsis and its complications by reducing the dysregulated inflammatory response. However, it remains unknown whether statins provide any protective effect on SAE. Methods: The data for this study were extracted from the MIMIC-IV database. Cox proportional hazards regression models were constructed to assess the association between statin therapy and mortality rate for in-hospital, 30-day, 90-day, 180-day, and 365-day. Kaplan-Meier survival curves were used to estimate survival probabilities between the non-statin group and statin group. Subgroup analysis was conducted to investigate potential variations in the effects of statin treatment on clinical outcomes among different groups. Results: A total of 4,707 patients with SAE were included in the study, with 2,387 in the non-statin group and 2,320 in the statin group. The findings indicated that the use of statins was linked to a considerable decrease in mortality rates. Patients who were administered statins experienced lower in-hospital mortality and demonstrated enhanced survival rates at 30, 90, 180, and 365 days when compared to those not receiving statins. Further analysis of atorvastatin showed that the subgroup exhibited a similarly consistent reduction in mortality across all time points in comparison to the non-statin group. Interestingly, the protective effect associated with statin use remained significant regardless of the statin type, dosage, or exposure time. Conclusions: The use of statins was associated with short-term and long-term mortality among SAE patients admitted to the ICU. This association was observed irrespective of statin type, dosage, or exposure time. It is necessary to conduct large-scale prospective studies to further explore the relationship between statins and the prognosis of patients with SAE.

Summary

Keywords

MIMIC IV database, Mortality, Sepsis-associated encephalopathy (SAE), statin, Statins

Received

29 November 2025

Accepted

09 February 2026

Copyright

© 2026 Huang, Yi, Li, Gong and Zhou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Tieqiao Zhou

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