title: Comparison of Dexmedetomidine Versus Propofol on Hospital Costs and Length of Stay.
abstract: OBJECTIVE
  The objective of this evaluation was to compare total hospital costs and length of stay of critically ill patients who received dexmedetomidine versus propofol for sedation in the intensive care unit (ICU).
  
  
  METHODS
  This was a retrospective quality improvement evaluation at a tertiary care, academic medical center in the United States. Data were retrieved for patients discharged between April 2012 and June 2013. Patients were included if they were admitted to the ICU, were 18 years of age or older, and received dexmedetomidine or propofol for sedation. Multivariate regression models were developed to determine the association between sedative type and hospital costs, ICU length of stay, and hospital length of stay.
  
  
  RESULTS
  The final cohort included 3294 patients. Of these, 2685 received propofol and 609 received dexmedetomidine. The median hospital cost was US$31 041 (interquartile range [IQR] US$17 963-US$57 826) in the propofol group and US$46 716 (IQR US$31 247 to US$85 490) in the dexmedetomidine group (P < .001). The median ICU length of stay was 2 days (IQR 1-6 days) and 4 days (IQR 2-9 days) in the propofol and dexmedetomidine groups, respectively (P < .001). Overall, hospital length of stay was 8 days (IQR 4-15 days) and 9 days (IQR 5-18 days) in the 2 groups, respectively (P < .001). In the multivariate analyses, dexmedetomidine use was associated with increased costs, ICU length of stay, and hospital length of stay (P < .001 for each outcome).
  
  
  CONCLUSIONS
  In this academic medical center, dexmedetomidine use was associated with higher costs when compared to propofol for sedation in the ICU. Also, use of dexmedetomidine was associated with increased lengths of ICU and hospital stay. Future prospective trials are needed to confirm these findings.
authors: Department of Pharmacy Practice and Science, College of Pharmacy, The University of Arizona, Tucson, AZ, USA patanwala@pharmacy.arizona.edu.
authors: Asad E
authors: AE
authors: Patanwala
authors: Department of Pharmacy Practice and Science, College of Pharmacy, The University of Arizona, Tucson, AZ, USA.
authors: Brian L
authors: BL
authors: Erstad
mesh_terms: D000328:Adult; D000368:Aged; D016292:Procedural Sedation; D003422:Critical Care / Q000191:economics*; D016638:Critical Illness / Q000191:economics / Q000628:therapy*; D020927:Dexmedetomidine / Q000191:economics; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000191:economics; D007362:Intensive Care Units / Q000191:economics / Q000706:statistics & numerical data; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015742:Propofol / Q000191:economics; D058996:Quality Improvement; D012189:Retrospective Studies; D014481:United States
chemical_list: D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine; D015742:Propofol
keywords: costs and cost analysis; critical care; dexmedetomidine; propofol