The Effect of Dexmedetomidine on Outcomes of Cardiac Surgery in Elderly Patients

Hao Cheng, Zhongmin Li, J Nilas Young, Walter D Boyd, Zane Atkins, Fuhai Ji, Hong Liu

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Objective The goal of this retrospective study was to investigate the effects of perioperative use of dexmedetomidine (Dex) on outcomes for older patients undergoing cardiac surgery. Design Retrospective investigation. Setting Patients from a single tertiary medical center. Participants A total of 505 patients (≥65 years old) who underwent coronary artery bypass graft (CABG) or valve surgery. CABG and/or valve surgery plus other procedures were divided into 2 groups: 283 received intravenous Dex infusion (Dex group) and 222 did not (Non-Dex group). Interventions Perioperative Dex intravenous infusion (0.24 to 0.6 μg/kg/h) initiated after cardiopulmonary bypass and continued for<24 hours postoperatively in the ICU. Measurements and Main Results Data were risk adjusted, propensity score weighted, and multivariate logistic regression was used. The primary outcome was mortality. Secondary outcomes included postoperative stroke, coma, myocardial infarction, heart block, cardiac arrest, delirium, renal failure, and sepsis. Perioperative Dex infusion significantly decreased in-hospital mortality (0.90% v 2.83%; adjusted odds ratio (OR), 0.099; 95% confidence interval (CI), 0.030-0.324; p = 0.004) and operative mortality (1.35% v 3.18%; adjusted OR, 0.251; 95% CI, 0.077-0.813; p = 0.021). Perioperative Dex treatment also reduced the risk of stroke (0.90% v 1.77%; adjusted OR, 0.15; 95% CI, 0.038-0.590; p = 0.007), and delirium (7.21% v 10.95%; adjusted OR, 0.35; 95% CI, 0.212-0.578; p < 0.0001). Conclusions Results from this study (ClinicalTrials.gov identifier: NCT01683448) suggested perioperative use of dexmedetomidine was associated with decreases in in-hospital and operative mortality in elderly patients following cardiac surgery. It also reduced incidences of postoperative stroke and delirium in elderly patients.

Original languageEnglish (US)
Pages (from-to)1502-1508
Number of pages7
JournalJournal of Cardiothoracic and Vascular Anesthesia
Volume30
Issue number6
DOIs
StatePublished - Dec 1 2016

Fingerprint

Dexmedetomidine
Thoracic Surgery
Delirium
Odds Ratio
Confidence Intervals
Stroke
Hospital Mortality
Intravenous Infusions
Coronary Artery Bypass
Transplants
Propensity Score
Heart Block
Mortality
Coma
Heart Arrest
Cardiopulmonary Bypass
Renal Insufficiency
Sepsis
Retrospective Studies
Logistic Models

Keywords

  • dexmedetomidine
  • elderly cardiac surgery
  • hospital mortality
  • outcome operative mortality

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Anesthesiology and Pain Medicine

Cite this

The Effect of Dexmedetomidine on Outcomes of Cardiac Surgery in Elderly Patients. / Cheng, Hao; Li, Zhongmin; Young, J Nilas; Boyd, Walter D; Atkins, Zane; Ji, Fuhai; Liu, Hong.

In: Journal of Cardiothoracic and Vascular Anesthesia, Vol. 30, No. 6, 01.12.2016, p. 1502-1508.

Research output: Contribution to journalArticle

Cheng, Hao ; Li, Zhongmin ; Young, J Nilas ; Boyd, Walter D ; Atkins, Zane ; Ji, Fuhai ; Liu, Hong. / The Effect of Dexmedetomidine on Outcomes of Cardiac Surgery in Elderly Patients. In: Journal of Cardiothoracic and Vascular Anesthesia. 2016 ; Vol. 30, No. 6. pp. 1502-1508.
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N2 - Objective The goal of this retrospective study was to investigate the effects of perioperative use of dexmedetomidine (Dex) on outcomes for older patients undergoing cardiac surgery. Design Retrospective investigation. Setting Patients from a single tertiary medical center. Participants A total of 505 patients (≥65 years old) who underwent coronary artery bypass graft (CABG) or valve surgery. CABG and/or valve surgery plus other procedures were divided into 2 groups: 283 received intravenous Dex infusion (Dex group) and 222 did not (Non-Dex group). Interventions Perioperative Dex intravenous infusion (0.24 to 0.6 μg/kg/h) initiated after cardiopulmonary bypass and continued for<24 hours postoperatively in the ICU. Measurements and Main Results Data were risk adjusted, propensity score weighted, and multivariate logistic regression was used. The primary outcome was mortality. Secondary outcomes included postoperative stroke, coma, myocardial infarction, heart block, cardiac arrest, delirium, renal failure, and sepsis. Perioperative Dex infusion significantly decreased in-hospital mortality (0.90% v 2.83%; adjusted odds ratio (OR), 0.099; 95% confidence interval (CI), 0.030-0.324; p = 0.004) and operative mortality (1.35% v 3.18%; adjusted OR, 0.251; 95% CI, 0.077-0.813; p = 0.021). Perioperative Dex treatment also reduced the risk of stroke (0.90% v 1.77%; adjusted OR, 0.15; 95% CI, 0.038-0.590; p = 0.007), and delirium (7.21% v 10.95%; adjusted OR, 0.35; 95% CI, 0.212-0.578; p < 0.0001). Conclusions Results from this study (ClinicalTrials.gov identifier: NCT01683448) suggested perioperative use of dexmedetomidine was associated with decreases in in-hospital and operative mortality in elderly patients following cardiac surgery. It also reduced incidences of postoperative stroke and delirium in elderly patients.

AB - Objective The goal of this retrospective study was to investigate the effects of perioperative use of dexmedetomidine (Dex) on outcomes for older patients undergoing cardiac surgery. Design Retrospective investigation. Setting Patients from a single tertiary medical center. Participants A total of 505 patients (≥65 years old) who underwent coronary artery bypass graft (CABG) or valve surgery. CABG and/or valve surgery plus other procedures were divided into 2 groups: 283 received intravenous Dex infusion (Dex group) and 222 did not (Non-Dex group). Interventions Perioperative Dex intravenous infusion (0.24 to 0.6 μg/kg/h) initiated after cardiopulmonary bypass and continued for<24 hours postoperatively in the ICU. Measurements and Main Results Data were risk adjusted, propensity score weighted, and multivariate logistic regression was used. The primary outcome was mortality. Secondary outcomes included postoperative stroke, coma, myocardial infarction, heart block, cardiac arrest, delirium, renal failure, and sepsis. Perioperative Dex infusion significantly decreased in-hospital mortality (0.90% v 2.83%; adjusted odds ratio (OR), 0.099; 95% confidence interval (CI), 0.030-0.324; p = 0.004) and operative mortality (1.35% v 3.18%; adjusted OR, 0.251; 95% CI, 0.077-0.813; p = 0.021). Perioperative Dex treatment also reduced the risk of stroke (0.90% v 1.77%; adjusted OR, 0.15; 95% CI, 0.038-0.590; p = 0.007), and delirium (7.21% v 10.95%; adjusted OR, 0.35; 95% CI, 0.212-0.578; p < 0.0001). Conclusions Results from this study (ClinicalTrials.gov identifier: NCT01683448) suggested perioperative use of dexmedetomidine was associated with decreases in in-hospital and operative mortality in elderly patients following cardiac surgery. It also reduced incidences of postoperative stroke and delirium in elderly patients.

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