Comparative Analysis of Dexmedetomidine, Midazolam, and Propofol Impact on Epilepsy- Related Mortality in the ICU: Insights from the MIMIC-IV Database

Abstract

Background Dexmedetomidine (Dex), midazolam, and propofol are three distinct sedatives characterized by varying pharmacological properties. Previous literature has indicated the positive impact of each of these sedatives on ICU patients. This study aimed to assess the impact of Dex, midazolam, and propofol on the survival of PWE. Methods Retrospective data were obtained from the Medical Information Mart for Intensive Care (MIMIC)-IV database (version 2.0). PWE were categorized into Dex, midazolam, and propofol groups based on intravenously administered sedatives. PWE without standard drug therapy were included in the control group. Comparative analyses were performed on the data among the groups. Results Kaplan-Meier curves demonstrated a significant improvement in survival rates for the Dex group compared to the control group (p = 0.025). Analysis of Variance (ANOVA) revealed no significant differences in survival rates among the Dex, midazolam, and propofol groups (F = 1.949, p = 0.143). The nomogram indicated that compared to midazolam and propofol groups, Dex was more effective in improving the survival rate of PWE. Conclusion Dex might appear to outperform midazolam and propofol in improving the survival rate in nomogram.