Cardiothoracic & vascular anesthesia
Combined Propofol and Dexmedetomidine Is Associated with Lower Mortality but Not Delirium After Cardiovascular Surgery: A Retrospective Cohort Study Using an Administrative Claims Database
Main finding · 28-day mortalityResult — go to the resultHazard ratio 0.77 95% CI 0.63–0.93Authors' conclusion
This large-scale, real-world study found that PRODEX was associated with a significant decrease in 28- and 90-day mortality. However, PRODEX did not reduce the incidence of POD compared to propofol monotherapy.
Study context
- Population
- Patients undergoing cardiovascular surgery, Japanese nationwide administrative claims database (>400 acute care hospitals)
- Participants
- 23,629 patients
- Exposure
- Combined propofol and dexmedetomidine vs propofol monotherapy sedation
- Propofol and dexmedetomidine (PRODEX)n = 9,671
- Propofoln = 13,958reference
- Outcome
- 28-day mortality
- Follow-up
- 28 days
Methodological detailsnationwide administrative claims database
- Nationwide administrative claims database
Main finding
As reported in the abstract
Hazard ratio
0.77
95% CI 0.63–0.93
P < 0.01
PRODEX vs Propofol
HR 0.77 (95% CI 0.63–0.93); P < 0.01
Observational data: associations, not effects.
Secondary outcomes
| Outcome | Estimate | P value | |
|---|---|---|---|
| 90-day mortality | HR 0.82 (95% CI 0.69–0.96) | P = 0.01 | |
| POD riskFine and Gray model · no significant difference | subdistribution HR 1.01 (95% CI 0.94–1.08) | P = 0.81 | |
| 0.512Ratio (log scale) |
Original publication
Combined Propofol and Dexmedetomidine Is Associated with Lower Mortality but Not Delirium After Cardiovascular Surgery: A Retrospective Cohort Study Using an Administrative Claims Database. J Cardiothorac Vasc Anesth. Published 29 November 2025. doi:10.
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