PDF(Pubmed)
Abstract：
BACKGROUND: Dexmedetomidine (Dex), midazolam, and propofol are three distinct sedatives characterized by varying pharmacological properties. Previous literature has indicated the positive impact of each of these sedatives on ICU patients. However, there is a scarcity of clinical evidence comparing the efficacy of Dex, midazolam, and propofol in reducing mortality among people with epilepsy (PWE). This study aimed to assess the impact of Dex, midazolam, and propofol on the survival of PWE.
METHODS: The data were retrospectively retrieved from the Medical Information Mart for Intensive Care (MIMIC)-IV database (version 2.0). PWE were categorized into Dex, midazolam, and propofol groups based on the intravenously administered sedatives. PWE without standard drug therapy were included in the control group. Comparative analyses were performed on the data among the groups.
RESULTS: The Dex group exhibited a significantly lower proportion of in-hospital deaths and a markedly higher in-hospital survival time compared to the midazolam and propofol groups (p < 0.01) after propensity score matching. Kaplan-Meier curves demonstrated a significant improvement in survival rates for the Dex group compared to the control group (p = 0.025). Analysis of Variance (ANOVA) revealed no significant differences in survival rates among the Dex, midazolam, and propofol groups (F = 1.949, p = 0.143). The nomogram indicated that compared to midazolam and propofol groups, Dex was more effective in improving the survival rate of PWE.
CONCLUSIONS: Dex might improve the survival rate of PWE in the ICU compared to no standard drug intervention. However, Dex did not exhibit superiority in improving survival rates compared to midazolam and propofol.
METHODS: The data were retrospectively retrieved from the Medical Information Mart for Intensive Care (MIMIC)-IV database (version 2.0). PWE were categorized into Dex, midazolam, and propofol groups based on the intravenously administered sedatives. PWE without standard drug therapy were included in the control group. Comparative analyses were performed on the data among the groups.
RESULTS: The Dex group exhibited a significantly lower proportion of in-hospital deaths and a markedly higher in-hospital survival time compared to the midazolam and propofol groups (p < 0.01) after propensity score matching. Kaplan-Meier curves demonstrated a significant improvement in survival rates for the Dex group compared to the control group (p = 0.025). Analysis of Variance (ANOVA) revealed no significant differences in survival rates among the Dex, midazolam, and propofol groups (F = 1.949, p = 0.143). The nomogram indicated that compared to midazolam and propofol groups, Dex was more effective in improving the survival rate of PWE.
CONCLUSIONS: Dex might improve the survival rate of PWE in the ICU compared to no standard drug intervention. However, Dex did not exhibit superiority in improving survival rates compared to midazolam and propofol.
摘要：
背景：右美托咪定（Dex），咪达唑仑,和异丙酚是三种不同的镇静剂，其特征在于不同的药理特性。先前的文献表明这些镇静剂中的每一种对ICU患者的积极影响。然而,缺乏比较Dex疗效的临床证据，咪达唑仑,和异丙酚可降低癫痫患者（PWE）的死亡率。本研究旨在评估Dex的影响，咪达唑仑,丙泊酚对PWE的成活率。
方法：从重症监护医疗信息集市（MIMIC）-IV数据库（2.0版）中回顾性检索数据。PWE被归类为Dex，咪达唑仑,和丙泊酚组基于静脉给药镇静剂。无标准药物治疗的PWE纳入对照组。对各组数据进行比较分析。
结果：倾向评分匹配后，与咪达唑仑和丙泊酚组相比，Dex组的住院死亡比例显著降低，住院生存时间显著延长（p<0.01）。Kaplan-Meier曲线表明,与对照组相比,Dex组的存活率显著提高(p=0.025)。方差分析（ANOVA）显示Dex之间的生存率没有显着差异，咪达唑仑,和异丙酚组（F=1.949，p=0.143）。列线图显示，与咪达唑仑组和丙泊酚组相比，Dex对提高PWE的成活率更为有效。
结论：与没有标准药物干预相比，Dex可能会提高ICU中PWE的生存率。然而,与咪达唑仑和异丙酚相比，Dex在提高生存率方面没有优势。
方法：从重症监护医疗信息集市（MIMIC）-IV数据库（2.0版）中回顾性检索数据。PWE被归类为Dex，咪达唑仑,和丙泊酚组基于静脉给药镇静剂。无标准药物治疗的PWE纳入对照组。对各组数据进行比较分析。
结果：倾向评分匹配后，与咪达唑仑和丙泊酚组相比，Dex组的住院死亡比例显著降低，住院生存时间显著延长（p<0.01）。Kaplan-Meier曲线表明,与对照组相比,Dex组的存活率显著提高(p=0.025)。方差分析（ANOVA）显示Dex之间的生存率没有显着差异，咪达唑仑,和异丙酚组（F=1.949，p=0.143）。列线图显示，与咪达唑仑组和丙泊酚组相比，Dex对提高PWE的成活率更为有效。
结论：与没有标准药物干预相比，Dex可能会提高ICU中PWE的生存率。然而,与咪达唑仑和异丙酚相比，Dex在提高生存率方面没有优势。
