Assessment of the Effects of Dexmedetomidine on Outcomes of Traumatic Brain Injury Using Propensity Score Analysis

Abstract Background: Dexmedetomidine has been found to be protective against traumatic brain injury(TBI) in animal studies and safe to for use in previous clinical studies, but whether it improves TBI patient survival remains to be determined. We sought to answer this question through the analysis of data from the MIMIC clinical database.Methods: Data from TBI patients from the MIMICⅢ and MIMICⅣ databases were extracted and divided into a dexmedetomidine group and a control group. In the former group, dexmedetomidine was used for sedation, while in the latter, it was not used. Parameters including patient age, sex, the Acute Physiology score Ⅲ, the Charlson Comorbidity Index score, the Glasgow Coma Scale, other sedatives used, and pupillary response within 24h were employed in propensity score matching to achieve a balance between groups for further analysis. The length of hospital stay and outcome upon discharge were used to perform survival analysis. Subgroup analysis was performed to consolidate the results. Results: Different types of survival analyses demonstrated the same trend. Dexmedetomidine significantly improved TBI patient survival in the univariate analysis, multivariate analysis, analysis based on propensity score matching, and analysis based on the inverse probability of treatment weighting. Different doses, durations, and start time did not alter the beneficial efficacy of dexmedetomidine.Conclusions: Dexmedetomidine can be used to improve the outcomes of TBI patients.