Dexmedetomidine improves clinical outcomes in sepsis-induced myocardial injury: a retrospective cohort study
BackgroundThe efficacy of dexmedetomidine (DEX) in treating sepsis-induced myocardial injury (SIMI) remains unclear. In this study, we explored the relationship between DEX use and clinical outcomes of patients with SIMI, focusing on the dosage and treatment duration.MethodsIn this retrospective coh...
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Frontiers Media S.A.
2025-01-01
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| author | Yuan Liu Jianjie Ouyang Cuicui Zhang Pingping Niu Pingping Niu Baoling Shang Baoling Shang Gengzhen Yao Gengzhen Yao Yongyong Shi Yongyong Shi Xu Zou Xu Zou |
| author_facet | Yuan Liu Jianjie Ouyang Cuicui Zhang Pingping Niu Pingping Niu Baoling Shang Baoling Shang Gengzhen Yao Gengzhen Yao Yongyong Shi Yongyong Shi Xu Zou Xu Zou |
| author_sort | Yuan Liu |
| collection | DOAJ |
| description | BackgroundThe efficacy of dexmedetomidine (DEX) in treating sepsis-induced myocardial injury (SIMI) remains unclear. In this study, we explored the relationship between DEX use and clinical outcomes of patients with SIMI, focusing on the dosage and treatment duration.MethodsIn this retrospective cohort analysis, we identified patients with SIMI from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database and categorized them into the DEX and non-DEX groups based on intensive care unit treatment. The baseline bias was reduced through propensity score matching (PSM). The primary outcome was 28-day mortality, whereas the secondary outcomes were in-hospital mortality and mortality rates at 7 days, 90 days, and 1 year. The association between DEX use and in-hospital mortality was assessed using Kaplan–Meier analysis and Cox proportional hazards models.ResultsAfter PSM, 373 patients in the DEX group were matched with 579 patients in the non-DEX group to achieve a balanced distribution of the covariates. The Cox regression model demonstrated a significant reduction in the 28-day mortality associated with DEX use, yielding a hazard ratio (HR) of 0.61 (95% confidence interval [CI]: 0.47–0.78, P < 0.001). In-hospital mortality also significantly decreased (HR = 0.43, 95% CI: 0.33–0.57, P < 0.001). Lower mortality rates were observed at 7 days, 90 days, and 1 year. DEX doses >0.4 μg/kg/h, particularly in the range of 0.400–0.612 μg/kg/h, total doses >3.113 mg during hospitalization, and treatment durations exceeding 72 h were associated with improved mortality risk at all intervals. Regarding DEX efficacy at 28 days, our subgroup analyses indicated a significant interaction between the Sequential Organ Failure Assessment score and invasive mechanical ventilation.ConclusionDEX administration was associated with improved in-hospital mortality and reduced mortality rates at 7 days, 28 days, 90 days, and 1 year in patients with SIMI. These findings require validation in future studies. |
| format | Article |
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| institution | Kabale University |
| issn | 1663-9812 |
| language | English |
| publishDate | 2025-01-01 |
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| spelling | doaj-art-3199c7808a604592aecbbe4cb432eae22025-01-15T06:10:49ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-01-011510.3389/fphar.2024.15291671529167Dexmedetomidine improves clinical outcomes in sepsis-induced myocardial injury: a retrospective cohort studyYuan Liu0Jianjie Ouyang1Cuicui Zhang2Pingping Niu3Pingping Niu4Baoling Shang5Baoling Shang6Gengzhen Yao7Gengzhen Yao8Yongyong Shi9Yongyong Shi10Xu Zou11Xu Zou12Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, ChinaSecond Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, ChinaSecond Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, ChinaSecond Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, ChinaDepartment of Cardiology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, ChinaSecond Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, ChinaDepartment of Cardiology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, ChinaSecond Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, ChinaDepartment of Cardiology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, ChinaDepartment of Anesthesiology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, ChinaGuangdong Provincial Hospital of Chinese Medicine, Guizhou Hospital, Guiyang, ChinaSecond Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, ChinaDepartment of Cardiology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, ChinaBackgroundThe efficacy of dexmedetomidine (DEX) in treating sepsis-induced myocardial injury (SIMI) remains unclear. In this study, we explored the relationship between DEX use and clinical outcomes of patients with SIMI, focusing on the dosage and treatment duration.MethodsIn this retrospective cohort analysis, we identified patients with SIMI from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database and categorized them into the DEX and non-DEX groups based on intensive care unit treatment. The baseline bias was reduced through propensity score matching (PSM). The primary outcome was 28-day mortality, whereas the secondary outcomes were in-hospital mortality and mortality rates at 7 days, 90 days, and 1 year. The association between DEX use and in-hospital mortality was assessed using Kaplan–Meier analysis and Cox proportional hazards models.ResultsAfter PSM, 373 patients in the DEX group were matched with 579 patients in the non-DEX group to achieve a balanced distribution of the covariates. The Cox regression model demonstrated a significant reduction in the 28-day mortality associated with DEX use, yielding a hazard ratio (HR) of 0.61 (95% confidence interval [CI]: 0.47–0.78, P < 0.001). In-hospital mortality also significantly decreased (HR = 0.43, 95% CI: 0.33–0.57, P < 0.001). Lower mortality rates were observed at 7 days, 90 days, and 1 year. DEX doses >0.4 μg/kg/h, particularly in the range of 0.400–0.612 μg/kg/h, total doses >3.113 mg during hospitalization, and treatment durations exceeding 72 h were associated with improved mortality risk at all intervals. Regarding DEX efficacy at 28 days, our subgroup analyses indicated a significant interaction between the Sequential Organ Failure Assessment score and invasive mechanical ventilation.ConclusionDEX administration was associated with improved in-hospital mortality and reduced mortality rates at 7 days, 28 days, 90 days, and 1 year in patients with SIMI. These findings require validation in future studies.https://www.frontiersin.org/articles/10.3389/fphar.2024.1529167/fulldexmedetomidinesepsismyocardial injurymortalityMIMIC-IV |
| spellingShingle | Yuan Liu Jianjie Ouyang Cuicui Zhang Pingping Niu Pingping Niu Baoling Shang Baoling Shang Gengzhen Yao Gengzhen Yao Yongyong Shi Yongyong Shi Xu Zou Xu Zou Dexmedetomidine improves clinical outcomes in sepsis-induced myocardial injury: a retrospective cohort study Frontiers in Pharmacology dexmedetomidine sepsis myocardial injury mortality MIMIC-IV |
| title | Dexmedetomidine improves clinical outcomes in sepsis-induced myocardial injury: a retrospective cohort study |
| title_full | Dexmedetomidine improves clinical outcomes in sepsis-induced myocardial injury: a retrospective cohort study |
| title_fullStr | Dexmedetomidine improves clinical outcomes in sepsis-induced myocardial injury: a retrospective cohort study |
| title_full_unstemmed | Dexmedetomidine improves clinical outcomes in sepsis-induced myocardial injury: a retrospective cohort study |
| title_short | Dexmedetomidine improves clinical outcomes in sepsis-induced myocardial injury: a retrospective cohort study |
| title_sort | dexmedetomidine improves clinical outcomes in sepsis induced myocardial injury a retrospective cohort study |
| topic | dexmedetomidine sepsis myocardial injury mortality MIMIC-IV |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2024.1529167/full |
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