title: Perioperative dexmedetomidine improves mortality in patients undergoing coronary artery bypass surgery.
abstract: OBJECTIVE
  This study retrospectively investigated the effect of dexmedetomidine on outcomes of patients undergoing coronary artery bypass graft (CABG) surgery.
  
  
  METHODS
  Retrospective investigation.
  
  
  METHODS
  Patients from a single tertiary medical center.
  
  
  METHODS
  A total of 724 patients undergoing CABG surgery met the inclusion criteria and were categorized into 2 groups: 345 in the dexmedetomidine group (DEX) and 379 in the nondexmedetomidine group (Non-DEX).
  
  
  METHODS
  Perioperative dexmedetomidine was used as an intravenous infusion (0.24 to 0.6 µg/kg/hour) initiated after cardiopulmonary bypass and continued for less than 24 hours postoperatively in the intensive care unit.
  
  
  RESULTS
  Major outcome measures of this study were in-hospital, 30-day and 1-year all-cause mortality, delirium and major adverse cardiocerebral events. Perioperative dexmedetomidine infusion was associated with significant reductions in in-hospital, 30-day, and 1-year mortalities, compared with the patients who did not received dexmedetomidine. In-hospital, 30-day, and 1-year mortalities were 1.5% and 4.0% (adjusted odds ratio [OR], 0.332; 95% CI, 0.155 to 0.708; p = 0.0044), 2.0% and 4.5% (adjusted OR, 0.487; 95% CI, 0.253 to 0.985; p = 0.0305), and 3.2% and 6.9% (adjusted OR 0.421; 95% CI, 0.247 to 0.718, p = 0.0015), respectively. Perioperative dexmedetomidine infusion was associated with a reduced risk of delirium from 7.9% to 4.6% (adjusted OR, 0.431; 95% CI, 0.265-0.701; p = 0.0007).
  
  
  CONCLUSIONS
  Dexmedetomidine infusion during CABG surgery was more likely to achieve improved in-hospital, 30-day, and 1-year survival rates, and a significantly lower incidence of delirium.
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China; Department of Anesthesiology and Pain Medicine, University of California Davis Health System, Sacramento, CA.
authors.forename: Fuhai
authors.initials: F
authors.lastname: Ji
authors.affiliation: Department of Internal Medicine, University of California Davis Health System, Sacramento, CA.
authors.forename: Zhongmin
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Surgery, University of California Davis Health System, Sacramento, CA.
authors.forename: Nilas
authors.initials: N
authors.lastname: Young
authors.affiliation: Department of Anesthesiology and Pain Medicine, University of California Davis Health System, Sacramento, CA.
authors.forename: Peter
authors.initials: P
authors.lastname: Moore
authors.affiliation: Department of Anesthesiology and Pain Medicine, University of California Davis Health System, Sacramento, CA. Electronic address: hualiu@ucdavis.edu.
authors.forename: Hong
authors.initials: H
authors.lastname: Liu
mesh_terms: D000316:Adrenergic alpha-Agonists / Q000008:administration & dosage / Q000627:therapeutic use*; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000379:methods* / Q000401:mortality; D015331:Cohort Studies; D001026:Coronary Artery Bypass / Q000379:methods* / Q000401:mortality; D003693:Delirium / Q000453:epidemiology; D020927:Dexmedetomidine / Q000008:administration & dosage / Q000627:therapeutic use*; D004562:Electrocardiography; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007262:Infusions, Intravenous; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011183:Postoperative Complications / Q000453:epidemiology; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000316:Adrenergic alpha-Agonists; D020927:Dexmedetomidine
keywords: coronary artery bypass graft; delirium; dexmedetomidine; mortality; outcomes