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- Title
Postoperative norepinephrine versus dopamine in patients undergoing noncardiac surgery: a propensitymatched analysis using a nationwide intensive care database.
- Authors
Yoshitaka Aoki; Mikio Nakajima; Sho Sugimura; Yasuhito Suzuki; Hiroshi Makino; Yukako Obata; Matsuyuki Doi; Yoshiki Nakajima
- Abstract
Background: Choosing catecholamines, such as norepinephrine and dopamine, for perioperative blood pressure control is essential for anesthesiologists and intensivists. However, studies specific to noncardiac surgery are limited. Therefore, we aimed to evaluate the effects of postoperative norepinephrine and dopamine on clinical outcomes in adult noncardiac surgery patients by analyzing a nationwide intensive care patient database. Methods: The Japanese Intensive care PAtient Database (JIPAD) was used for this multicenter retrospective study. Adult patients in the JIPAD who received norepinephrine or dopamine within 24 h after noncardiac surgery in 2018-2020 were included. We compared the norepinephrine and dopamine groups using a one-to-one propensity score matching analysis. The primary outcome was in-hospital mortality. Secondary outcomes were intensive care unit (ICU) mortality, hospital length of stay, and ICU length of stay. Results: A total of 6,236 eligible patients from 69 ICUs were allocated to the norepinephrine (n = 4,652) or dopamine (n = 1,584) group. Propensity score matching was used to create a matched cohort of 1,230 pairs. No differences in the in-hospital mortality was found between the two propensity score matched groups (risk difference: 0.41%, 95% CI [-1.15, 1.96], P = 0.608). Among the secondary outcomes, only the ICU length of stay was significantly shorter in the norepinephrine group than in the dopamine group (median length: 3 vs. 4 days, respectively; P < 0.001). Conclusions: In adult patients after noncardiac surgery, norepinephrine was not associated with decreased mortality but was associated with a shorter ICU length of stay than dopamine.
- Subjects
NORADRENALINE; DOPAMINE; DATABASES; CRITICAL care medicine; PROPENSITY score matching
- Publication
Korean Journal of Anesthesiology, 2023, Vol 76, Issue 5, p481
- ISSN
2005-6419
- Publication type
Article
- DOI
10.4097/kja.22805