Impact of dexmedetomidine on mortality in critically ill patients with acute kidney injury: a retrospective propensity score matching analysis

BMJ Open. 2023 Nov 15;13(11):e073675. doi: 10.1136/bmjopen-2023-073675.

Abstract

Objectives: This study sought to estimate the effect of dexmedetomidine (DEX) administration on mortality in critically ill patients with acute kidney injury (AKI).

Design: A retrospective cohort study.

Setting: The study sourced its data from the Multiparameter Intelligent Monitoring in Intensive Care Database IV (MIMIC-IV), a comprehensive database of intensive care unit patients.

Participants: A total of 15 754 critically ill patients with AKI were enrolled from the MIMIC-IV database.

Primary and secondary outcome: Primary outcome was in-hospital mortality and secondary outcome was 180-day mortality.

Results: 15 754 critically ill AKI patients were included in our analysis. We found that DEX use decreased in-hospital mortality risk by 38% (HR 0.62, 95% CI 0.55 to 0.70) and 180-day mortality risk by 23% (HR 0.77, 95% CI 0.69 to 0.85). After adjusting for confounding factors, DEX can reduce all three stages of AKI in in-hospital mortality.

Conclusions: Our retrospective cohort study suggests that DEX significantly correlates with decreased risk-adjusted in-hospital and 180-day mortality in critically ill AKI patients. Nonetheless, future randomised controlled trials are warranted to validate our findings.

Keywords: acute renal failure; adult intensive & critical care; intensive & critical care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Kidney Injury*
  • Critical Illness
  • Dexmedetomidine* / therapeutic use
  • Hospital Mortality
  • Humans
  • Intensive Care Units
  • Propensity Score
  • Retrospective Studies

Substances

  • Dexmedetomidine