{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T22:54:02Z","timestamp":1791672842403,"version":"4.3.4"},"reference-count":31,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T00:00:00Z","timestamp":1751587200000},"content-version":"unspecified","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,6,23]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study investigates the effects of dexmedetomidine on short-term and long-term survival rates in intensive care unit (ICU) patients with ischaemic stroke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This is a retrospective study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Data were sourced from the Medical Information Mart for Intensive Care IV database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>This study analysed 2816 patients with ischaemic stroke from the US Intensive Care database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Dexmedetomidine administration during the ICU stay was defined as the exposure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients were categorised into the dexmedetomidine group and the control group. Cox regression analysis was used to identify factors that may influence the 28-day mortality rate of patients with ischaemic stroke. High-risk factors were incorporated as covariates, and a 1:1 propensity score matching using the logit model was constructed to compare the prognosis between the two groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>The primary outcome was 28-day mortality. The secondary outcomes included in-hospital mortality, ICU length of stay, hospital length of stay, mechanical ventilation duration and 180-day mortality in discharged patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 2816 patients were included. Cox regression analysis revealed that dexmedetomidine use was associated with a reduced risk of 28-day mortality. Following propensity score matching, each group comprised 407 patients. Dexmedetomidine was found to improve 28-day mortality (27.8% vs 36.6%, p=0.007). However, it was also associated with the prolonged length of hospital and ICU stay (p=0.002). Among discharged patients, dexmedetomidine use was also associated with an improved 180-day mortality rate (p=0.0019).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The use of dexmedetomidine is associated with improved short-term and long-term prognosis in patients with ischaemic stroke and could potentially confer benefits in those receiving mechanical ventilation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-101395","type":"journal-article","created":{"date-parts":[[2025,7,5]],"date-time":"2025-07-05T09:45:32Z","timestamp":1751708732000},"page":"e101395","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Association between dexmedetomidine sedation and mortality in critically ill patients with ischaemic stroke: a retrospective study based on MIMIC-IV database"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9716-6773","authenticated-orcid":false,"given":"Yuecheng","family":"Yang","sequence":"first","affiliation":[{"name":"Anesthesiology, Fudan University Shanghai Cancer Center, Shanghai, China"},{"name":"Oncology, Shanghai Medical College, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8415-7696","authenticated-orcid":false,"given":"Jingying","family":"Zhang","sequence":"additional","affiliation":[{"name":"Oncology, Shanghai Medical College, Fudan University, Shanghai, China"},{"name":"Intensive Care Unit, Fudan University Shanghai Cancer Center, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7683-2817","authenticated-orcid":false,"given":"Haoyuan","family":"Wang","sequence":"additional","affiliation":[{"name":"Anesthesiology, Fudan University Shanghai Cancer Center, Shanghai, China"},{"name":"Oncology, Shanghai Medical College, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4244-5599","authenticated-orcid":false,"given":"Yunkui","family":"Zhang","sequence":"additional","affiliation":[{"name":"Anesthesiology, Fudan University Shanghai Cancer Center, Shanghai, China"},{"name":"Oncology, Shanghai Medical College, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3197-0427","authenticated-orcid":false,"given":"Jun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Anesthesiology, Fudan University Shanghai Cancer Center, Shanghai, China"},{"name":"Oncology, Shanghai Medical College, Fudan University, Shanghai, 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Endovascular Thrombectomy on long-term prognosis in patients with acute ischemic stroke (PPDET): study protocol for a randomized controlled trial","volume":"25","author":"Yang","year":"2024","journal-title":"Trials"},{"key":"2025121508161748000_15.7.e101395.12","doi-asserted-by":"crossref","DOI":"10.3389\/fphar.2024.1428210","article-title":"Dexmedetomidine administration is associated with improved outcomes in critically ill patients with acute myocardial infarction partly through its anti-inflammatory activity","volume":"15","author":"Liu","year":"2024","journal-title":"Front Pharmacol"},{"key":"2025121508161748000_15.7.e101395.13","doi-asserted-by":"crossref","DOI":"10.1016\/j.jclinane.2022.110960","article-title":"Association between dexmedetomidine administration and outcomes in critically ill patients with sepsis-associated acute kidney injury","volume":"83","author":"Hu","year":"2022","journal-title":"J Clin 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