Work

Association between dexmedetomidine sedation and mortality in critically ill patients with ischaemic stroke: a retrospective study based on MIMIC-IV database

Year: 2025

Type: article

Abstract: OBJECTIVE: This study investigates the effects of dexmedetomidine on short-term and long-term survival rates in intensive care unit (ICU) patients with ischaemic stroke. DESIGN: This is a retrospective study. SETTING: Data were sourced from the Medical Information Mart for Intensive Care IV database. PARTICIPANTS: This study analysed 2816 patients with ischaemic stroke from the US Intensive Care database. INTERVENTIONS: Dexmedetomidine administration during the ICU stay was defined as the exposure. METHODS: Patients were categorised into the dexmedetomidine group and the control group. Cox regression analysis was used to identify factors that may influence the 28-day mortality rate of patients with ischaemic stroke. High-risk factors were incorporated as covariates, and a 1:1 propensity score matching using the logit model was constructed to compare the prognosis between the two groups. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was 28-day mortality. The secondary outcomes included in-hospital mortality, ICU length of stay, hospital length of stay, mechanical ventilation duration and 180-day mortality in discharged patients. RESULTS: A total of 2816 patients were included. Cox regression analysis revealed that dexmedetomidine use was associated with a reduced risk of 28-day mortality. Following propensity score matching, each group comprised 407 patients. Dexmedetomidine was found to improve 28-day mortality (27.8% vs 36.6%, p=0.007). However, it was also associated with the prolonged length of hospital and ICU stay (p=0.002). Among discharged patients, dexmedetomidine use was also associated with an improved 180-day mortality rate (p=0.0019). CONCLUSION: The use of dexmedetomidine is associated with improved short-term and long-term prognosis in patients with ischaemic stroke and could potentially confer benefits in those receiving mechanical ventilation.

Source: BMJ Open

DOI: 10.1136/bmjopen-2025-101395

Authors: Yuecheng Yang, Jingying Zhang, Haoyuan Wang, Yunkui Zhang, Jun Zhang

Institutions: Shanghai Medical College of Fudan University, Fudan University, Fudan University Shanghai Cancer Center

Language: English

Topic: Anesthesia and Sedative Agents

Subfield: Anesthesiology and Pain Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,839