Competing risk analysis of dexmedetomidine use and postoperative outcomes in non-traumatic subarachnoid hemorrhage patients
Abstract Background Dexmedetomidine is widely used in critically ill patients, but its effects on postoperative outcomes in non-traumatic subarachnoid hemorrhage (SAH) patients remain unclear. This study focuses on exploring the impact of dexmedetomidine on postoperative respiratory failure (RF) and...
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2025-07-01
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| Series: | European Journal of Medical Research |
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| Online Access: | https://doi.org/10.1186/s40001-025-02962-0 |
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| author | Tian-hua Lin Zong-jie Wang Yun-yun Tu Mu-hua Dong Ting Qiu Wen-jie Lan Ying Chen |
| author_facet | Tian-hua Lin Zong-jie Wang Yun-yun Tu Mu-hua Dong Ting Qiu Wen-jie Lan Ying Chen |
| author_sort | Tian-hua Lin |
| collection | DOAJ |
| description | Abstract Background Dexmedetomidine is widely used in critically ill patients, but its effects on postoperative outcomes in non-traumatic subarachnoid hemorrhage (SAH) patients remain unclear. This study focuses on exploring the impact of dexmedetomidine on postoperative respiratory failure (RF) and in-hospital mortality. Methods The data were downloaded from the Medical Information Mart for Intensive Care (MIMIC-IV) database, including 817 non-traumatic SAH patients. Propensity score matching (PSM) was performed. Multivariable logistic regression, sensitivity, interaction, and subgroup analyses were used to examine the association between dexmedetomidine use and RF or in-hospital mortality. A competing risk model was employed, with RF defined as the event of interest and in-hospital mortality as the competing event, to evaluate the survival probabilities for both outcomes. Results Dexmedetomidine use was a risk factor for RF but a protective factor for in-hospital mortality both pre-/post-PSM (p < 0.05). The protective effect of dexmedetomidine on mortality was more pronounced in younger patients (≤ 62 years) and those without cerebrovascular disease. Competing risk analysis showed that even after adjusting for confounders, dexmedetomidine remained a significant protective factor for in-hospital mortality, but did not affect the incidence of RF. Conclusions Dexmedetomidine use in non-traumatic SAH patients significantly reduces in-hospital mortality but does not affect the incidence of postoperative RF. These findings highlight the importance of considering competing risks when evaluating the effects of dexmedetomidine on postoperative outcomes. |
| format | Article |
| id | doaj-art-1843c24be57740e5ad5ad86c97d2fbc5 |
| institution | DOAJ |
| issn | 2047-783X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
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| series | European Journal of Medical Research |
| spelling | doaj-art-1843c24be57740e5ad5ad86c97d2fbc52025-08-20T03:04:31ZengBMCEuropean Journal of Medical Research2047-783X2025-07-0130111210.1186/s40001-025-02962-0Competing risk analysis of dexmedetomidine use and postoperative outcomes in non-traumatic subarachnoid hemorrhage patientsTian-hua Lin0Zong-jie Wang1Yun-yun Tu2Mu-hua Dong3Ting Qiu4Wen-jie Lan5Ying Chen6Department of Anesthesiology, Longyan First Affiliated Hospital of Fujian Medical UniversityDepartment of Anesthesiology, Longyan First Affiliated Hospital of Fujian Medical UniversityDepartment of Anesthesiology, Longyan First Affiliated Hospital of Fujian Medical UniversityDepartment of Outpatient, Longyan First Affiliated Hospital of Fujian Medical UniversityDepartment of Anesthesiology, Longyan First Affiliated Hospital of Fujian Medical UniversityDepartment of Anesthesiology, Longyan First Affiliated Hospital of Fujian Medical UniversityDepartment of Anesthesiology, Longyan First Affiliated Hospital of Fujian Medical UniversityAbstract Background Dexmedetomidine is widely used in critically ill patients, but its effects on postoperative outcomes in non-traumatic subarachnoid hemorrhage (SAH) patients remain unclear. This study focuses on exploring the impact of dexmedetomidine on postoperative respiratory failure (RF) and in-hospital mortality. Methods The data were downloaded from the Medical Information Mart for Intensive Care (MIMIC-IV) database, including 817 non-traumatic SAH patients. Propensity score matching (PSM) was performed. Multivariable logistic regression, sensitivity, interaction, and subgroup analyses were used to examine the association between dexmedetomidine use and RF or in-hospital mortality. A competing risk model was employed, with RF defined as the event of interest and in-hospital mortality as the competing event, to evaluate the survival probabilities for both outcomes. Results Dexmedetomidine use was a risk factor for RF but a protective factor for in-hospital mortality both pre-/post-PSM (p < 0.05). The protective effect of dexmedetomidine on mortality was more pronounced in younger patients (≤ 62 years) and those without cerebrovascular disease. Competing risk analysis showed that even after adjusting for confounders, dexmedetomidine remained a significant protective factor for in-hospital mortality, but did not affect the incidence of RF. Conclusions Dexmedetomidine use in non-traumatic SAH patients significantly reduces in-hospital mortality but does not affect the incidence of postoperative RF. These findings highlight the importance of considering competing risks when evaluating the effects of dexmedetomidine on postoperative outcomes.https://doi.org/10.1186/s40001-025-02962-0DexmedetomidineNon-traumatic subarachnoid hemorrhageRespiratory failureIn-hospital mortalityCompeting risk analysis |
| spellingShingle | Tian-hua Lin Zong-jie Wang Yun-yun Tu Mu-hua Dong Ting Qiu Wen-jie Lan Ying Chen Competing risk analysis of dexmedetomidine use and postoperative outcomes in non-traumatic subarachnoid hemorrhage patients European Journal of Medical Research Dexmedetomidine Non-traumatic subarachnoid hemorrhage Respiratory failure In-hospital mortality Competing risk analysis |
| title | Competing risk analysis of dexmedetomidine use and postoperative outcomes in non-traumatic subarachnoid hemorrhage patients |
| title_full | Competing risk analysis of dexmedetomidine use and postoperative outcomes in non-traumatic subarachnoid hemorrhage patients |
| title_fullStr | Competing risk analysis of dexmedetomidine use and postoperative outcomes in non-traumatic subarachnoid hemorrhage patients |
| title_full_unstemmed | Competing risk analysis of dexmedetomidine use and postoperative outcomes in non-traumatic subarachnoid hemorrhage patients |
| title_short | Competing risk analysis of dexmedetomidine use and postoperative outcomes in non-traumatic subarachnoid hemorrhage patients |
| title_sort | competing risk analysis of dexmedetomidine use and postoperative outcomes in non traumatic subarachnoid hemorrhage patients |
| topic | Dexmedetomidine Non-traumatic subarachnoid hemorrhage Respiratory failure In-hospital mortality Competing risk analysis |
| url | https://doi.org/10.1186/s40001-025-02962-0 |
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