Association Between Dexmedetomidine Use and Outcomes in Intensive Care Unit Patients with Sepsis: A Cohort Study

Abstract Sepsis is a fatal illness worldwide, particularly in the intensive care unit(ICU), and effective treatments for sepsis are currently scarce. The sedative medicine dexmedetomidine(DEX) has been found to reduce mortality in septic rats. Nevertheless, the association between DEX and mortality in septic patients remains disputed. We aimed to assess the relationship between the two. In this cohort study, We included patients with sepsis from the Medical Information Mart for Intensive Care (MIMIC)-Ⅳ database between 2008 and 2019. The primary outcome was overall in-hospital mortality. The secondary outcomes were 30-day mortality and length of hospital stay (hospital LOS). We used multivariable Cox regression and propensity score analyses to obtain an adjusted hazard ratio (HR) with 95% confidence. A total of 22633 sepsis patients were included, of whom 51.53% were female. DEX use was associated with lower overall in-hospital mortality [12.8% vs. 15.7%,HR 0.55; P < 0.001], reduced 30-day mortality [14.1% vs. 19.7%,HR 0.51;P < 0.001], and longer hospital LOS [13.7 d vs. 7.7 d,HR 6.51; P < 0.001]. The results are consistent across sensitivity and subgroup analyses, as well as propensity score matching. DEX use may be linked to decreased risk-adjusted mortality in sepsis patients. Additional clinical research is needed to confirm and validate this connection.