ORIGINAL RESEARCH article
Front. Neurol.
Sec. Neurocritical and Neurohospitalist Care
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1571957
Dexmedetomidine administration is associated with a reduced risk of ICU mortality in critically ill patients with ischemic stroke
Provisionally accepted
- 1Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China
- 2Chengdu Public Health Clinical Medical Center, Chengdu, China
- 3Guangzhou First People's Hospital, Guangzhou, Guangdong Province, China
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Background: Although the administration of dexmedetomidine (DEX) in intensive care unit (ICU) is rapidly increasing, its potential impact on critically ill patients with ischemic stroke has not yet been explored. Methods: Patient data were extracted from the Medical Information Mart for Intensive Care IV (MIMIC-IV 3.0) database to identify patients who received DEX and those who did not. The primary outcome was ICU mortality. Statistical analyses included multivariate Cox proportional hazards regression, propensity score matching (PSM), and inverse probability of treatment weighting (IPTW) to ensure the robustness of the findings. Results: This study included 646 patients (22.8%) with ischemic stroke who received DEX treatment, and 2,182 patients who did not receive DEX in the ICU. A significant reduction in ICU mortality was observed in the DEX group compared to the non-DEX group, with an adjusted hazard ratio (HR) of 0.52 [95% confidence interval (CI) 0.40-0.68, P < 0.001). Within the matched cohort, DEX administration did not show a statistically significant increased risk of bradycardia and improvement in 90-day mortality outcomes. Conclusions: These findings suggest that DEX administration may reduce ICU mortality in patients with IS.
Keywords: ischemic stroke, Dexmedetomidine, Intensive Care Unit, Mortality, Sedative
Received: 10 Mar 2025; Accepted: 21 Jul 2025.
Copyright: © 2025 Chen, Ren, Li and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Kewei Liu, Guangzhou First People's Hospital, Guangzhou, 510180, Guangdong Province, China
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