Perioperative dexmedetomidine improves mortality in patients undergoing coronary artery bypass surgery

Fuhai Ji, Zhongmin Li, J Nilas Young, Peter G Moore, Hong Liu

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Objective This study retrospectively investigated the effect of dexmedetomidine on outcomes of patients undergoing coronary artery bypass graft (CABG) surgery. Design Retrospective investigation. Setting Patients from a single tertiary medical center. Participants A total of 724 patients undergoing CABG surgery met the inclusion criteria and were categorized into 2 groups: 345 in the dexmedetomidine group (DEX) and 379 in the nondexmedetomidine group (Non-DEX). Interventions Perioperative dexmedetomidine was used as an intravenous infusion (0.24 to 0.6 μg/kg/hour) initiated after cardiopulmonary bypass and continued for less than 24 hours postoperatively in the intensive care unit. Measurements and Main Results Major outcome measures of this study were in-hospital, 30-day and 1-year all-cause mortality, delirium and major adverse cardiocerebral events. Perioperative dexmedetomidine infusion was associated with significant reductions in in-hospital, 30-day, and 1-year mortalities, compared with the patients who did not received dexmedetomidine. In-hospital, 30-day, and 1-year mortalities were 1.5% and 4.0% (adjusted odds ratio [OR], 0.332; 95% CI, 0.155 to 0.708; p = 0.0044), 2.0% and 4.5% (adjusted OR, 0.487; 95% CI, 0.253 to 0.985; p = 0.0305), and 3.2% and 6.9% (adjusted OR 0.421; 95% CI, 0.247 to 0.718, p = 0.0015), respectively. Perioperative dexmedetomidine infusion was associated with a reduced risk of delirium from 7.9% to 4.6% (adjusted OR, 0.431; 95% CI, 0.265-0.701; p = 0.0007). Conclusion Dexmedetomidine infusion during CABG surgery was more likely to achieve improved in-hospital, 30-day, and 1-year survival rates, and a significantly lower incidence of delirium.

Original languageEnglish (US)
Pages (from-to)267-273
Number of pages7
JournalJournal of Cardiothoracic and Vascular Anesthesia
Volume28
Issue number2
DOIs
StatePublished - 2014

Fingerprint

Dexmedetomidine
Coronary Artery Bypass
Mortality
Delirium
Odds Ratio
Transplants
Outcome Assessment (Health Care)
Cardiopulmonary Bypass
Intravenous Infusions
Intensive Care Units
Survival Rate
Incidence

Keywords

  • coronary artery bypass graft
  • delirium
  • dexmedetomidine
  • mortality
  • outcomes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Anesthesiology and Pain Medicine

Cite this

Perioperative dexmedetomidine improves mortality in patients undergoing coronary artery bypass surgery. / Ji, Fuhai; Li, Zhongmin; Young, J Nilas; Moore, Peter G; Liu, Hong.

In: Journal of Cardiothoracic and Vascular Anesthesia, Vol. 28, No. 2, 2014, p. 267-273.

Research output: Contribution to journalArticle

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abstract = "Objective This study retrospectively investigated the effect of dexmedetomidine on outcomes of patients undergoing coronary artery bypass graft (CABG) surgery. Design Retrospective investigation. Setting Patients from a single tertiary medical center. Participants A total of 724 patients undergoing CABG surgery met the inclusion criteria and were categorized into 2 groups: 345 in the dexmedetomidine group (DEX) and 379 in the nondexmedetomidine group (Non-DEX). Interventions Perioperative dexmedetomidine was used as an intravenous infusion (0.24 to 0.6 μg/kg/hour) initiated after cardiopulmonary bypass and continued for less than 24 hours postoperatively in the intensive care unit. Measurements and Main Results Major outcome measures of this study were in-hospital, 30-day and 1-year all-cause mortality, delirium and major adverse cardiocerebral events. Perioperative dexmedetomidine infusion was associated with significant reductions in in-hospital, 30-day, and 1-year mortalities, compared with the patients who did not received dexmedetomidine. In-hospital, 30-day, and 1-year mortalities were 1.5{\%} and 4.0{\%} (adjusted odds ratio [OR], 0.332; 95{\%} CI, 0.155 to 0.708; p = 0.0044), 2.0{\%} and 4.5{\%} (adjusted OR, 0.487; 95{\%} CI, 0.253 to 0.985; p = 0.0305), and 3.2{\%} and 6.9{\%} (adjusted OR 0.421; 95{\%} CI, 0.247 to 0.718, p = 0.0015), respectively. Perioperative dexmedetomidine infusion was associated with a reduced risk of delirium from 7.9{\%} to 4.6{\%} (adjusted OR, 0.431; 95{\%} CI, 0.265-0.701; p = 0.0007). Conclusion Dexmedetomidine infusion during CABG surgery was more likely to achieve improved in-hospital, 30-day, and 1-year survival rates, and a significantly lower incidence of delirium.",
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AU - Young, J Nilas

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AU - Liu, Hong

PY - 2014

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N2 - Objective This study retrospectively investigated the effect of dexmedetomidine on outcomes of patients undergoing coronary artery bypass graft (CABG) surgery. Design Retrospective investigation. Setting Patients from a single tertiary medical center. Participants A total of 724 patients undergoing CABG surgery met the inclusion criteria and were categorized into 2 groups: 345 in the dexmedetomidine group (DEX) and 379 in the nondexmedetomidine group (Non-DEX). Interventions Perioperative dexmedetomidine was used as an intravenous infusion (0.24 to 0.6 μg/kg/hour) initiated after cardiopulmonary bypass and continued for less than 24 hours postoperatively in the intensive care unit. Measurements and Main Results Major outcome measures of this study were in-hospital, 30-day and 1-year all-cause mortality, delirium and major adverse cardiocerebral events. Perioperative dexmedetomidine infusion was associated with significant reductions in in-hospital, 30-day, and 1-year mortalities, compared with the patients who did not received dexmedetomidine. In-hospital, 30-day, and 1-year mortalities were 1.5% and 4.0% (adjusted odds ratio [OR], 0.332; 95% CI, 0.155 to 0.708; p = 0.0044), 2.0% and 4.5% (adjusted OR, 0.487; 95% CI, 0.253 to 0.985; p = 0.0305), and 3.2% and 6.9% (adjusted OR 0.421; 95% CI, 0.247 to 0.718, p = 0.0015), respectively. Perioperative dexmedetomidine infusion was associated with a reduced risk of delirium from 7.9% to 4.6% (adjusted OR, 0.431; 95% CI, 0.265-0.701; p = 0.0007). Conclusion Dexmedetomidine infusion during CABG surgery was more likely to achieve improved in-hospital, 30-day, and 1-year survival rates, and a significantly lower incidence of delirium.

AB - Objective This study retrospectively investigated the effect of dexmedetomidine on outcomes of patients undergoing coronary artery bypass graft (CABG) surgery. Design Retrospective investigation. Setting Patients from a single tertiary medical center. Participants A total of 724 patients undergoing CABG surgery met the inclusion criteria and were categorized into 2 groups: 345 in the dexmedetomidine group (DEX) and 379 in the nondexmedetomidine group (Non-DEX). Interventions Perioperative dexmedetomidine was used as an intravenous infusion (0.24 to 0.6 μg/kg/hour) initiated after cardiopulmonary bypass and continued for less than 24 hours postoperatively in the intensive care unit. Measurements and Main Results Major outcome measures of this study were in-hospital, 30-day and 1-year all-cause mortality, delirium and major adverse cardiocerebral events. Perioperative dexmedetomidine infusion was associated with significant reductions in in-hospital, 30-day, and 1-year mortalities, compared with the patients who did not received dexmedetomidine. In-hospital, 30-day, and 1-year mortalities were 1.5% and 4.0% (adjusted odds ratio [OR], 0.332; 95% CI, 0.155 to 0.708; p = 0.0044), 2.0% and 4.5% (adjusted OR, 0.487; 95% CI, 0.253 to 0.985; p = 0.0305), and 3.2% and 6.9% (adjusted OR 0.421; 95% CI, 0.247 to 0.718, p = 0.0015), respectively. Perioperative dexmedetomidine infusion was associated with a reduced risk of delirium from 7.9% to 4.6% (adjusted OR, 0.431; 95% CI, 0.265-0.701; p = 0.0007). Conclusion Dexmedetomidine infusion during CABG surgery was more likely to achieve improved in-hospital, 30-day, and 1-year survival rates, and a significantly lower incidence of delirium.

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