Perioperative medicine & outcomes
Effect of intraoperative dexmedetomidine on long-term survival in older patients after major noncardiac surgery: 3-year follow-up of a randomized trial
Primary result · Overall survival (deaths)Result — go to the resultAHR for death 0.78 95% CI 0.53–1.13Authors' conclusion
In older patients having major noncardiac surgery mainly for cancer, intraoperative dexmedetomidine did not improve overall survival but was associated with improved recurrence-free and event-free survivals.
Study context
- Population
- Patients aged ≥60 years scheduled for major noncardiac surgery (mainly for cancer), tertiary hospital in Beijing, China619 analysed
- Participants
- 620 patients
- Comparison
- Intraoperative dexmedetomidine vs placebo
- Dexmedetomidinen = 309
- Placebon = 310reference
- Primary endpoint
- Overall survival
Methodological detailsplacebo-controlled, single-centre, propensity-score matching sensitivity analysis, Median follow-up 42 months (IQR 41 to 45)
- Placebo-controlled
- Single-centre
- Propensity-score matching sensitivity analysis
- Median follow-up 42 months (IQR 41 to 45)
Primary result
Overall survival (deaths)
AHR for death
0.78
95% CI 0.53–1.13
P = 0.187
Events by treatment group
Dexmedetomidine vs Placebo
aHR for death 0.78 (95% CI 0.53–1.13); P = 0.187
As reported in the abstract
Secondary outcomes
| Outcome | Dexmedetomidine | Placebo | Estimate | P value | |
|---|---|---|---|---|---|
| Recurrence-free survival (recurrence or death events) | 22.0% | 31.6% | aHR for recurrence-free survival events 0.67 (95% CI 0.49–0.92) | P = 0.012 | |
| Event-free survival (events) | 38.8% | 46.8% | aHR for event-free survival events 0.78 (95% CI 0.61–1.00) | P = 0.047 | |
| 0.512Ratio (log scale) |
Propensity-score matched analysis and cancer subgroup (subgroup)
- Results were similar after propensity-score matching and in the subgroup of cancer patients
Original publication
Effect of intraoperative dexmedetomidine on long-term survival in older patients after major noncardiac surgery: 3-year follow-up of a randomized trial. J Clin Anesth. Published 1 February 2023. doi:10.
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