Association Between Premorbid Beta-Blocker Exposure and Sepsis Outcomes—The Beta-Blockers in European and Australian/American Septic Patients (BEAST) Study
| Autor: | Marek Nalos, Andrew Simpson, Christina Whitehead, Kristy P. Robledo, Gunawan Gunawan, Yi Chern Tan, Anthony S. McLean, Martin Harazim, Kaiquan Tan, Benjamin Tang |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.drug_class Adrenergic beta-Antagonists Critical Care and Intensive Care Medicine Sepsis Internal medicine Outcome Assessment Health Care Odds Ratio medicine Humans Beta blocker APACHE Aged Czech Republic Proportional Hazards Models Retrospective Studies Proportional hazards model business.industry Organ dysfunction Hazard ratio Retrospective cohort study Odds ratio Middle Aged medicine.disease United States Female Observational study New South Wales medicine.symptom business |
| Zdroj: | Critical Care Medicine. 49:1493-1503 |
| ISSN: | 0090-3493 |
| DOI: | 10.1097/ccm.0000000000005034 |
| Popis: | Objectives To examine the effect of premorbid β-blocker exposure on mortality and organ dysfunction in sepsis. Design Retrospective observational study. Setting ICUs in Australia, the Czech Republic, and the United States. Patients Total of 4,086 critical care patients above 18 years old with sepsis between January 2014 and December 2018. Intervention Premorbid beta-blocker exposure. Measurements and main results One thousand five hundred fifty-six patients (38%) with premorbid β-blocker exposure were identified. Overall ICU mortality rate was 15.1%. In adjusted models, premorbid β-blocker exposure was associated with decreased ICU (adjusted odds ratio, 0.80; 95% CI, 0.66-0.97; p = 0.025) and hospital (adjusted odds ratio, 0.83; 95% CI, 0.71-0.99; p = 0.033) mortality. The risk reduction in ICU mortality of 16% was significant (hazard ratio, 0.84, 95% CI, 0.71-0.99; p = 0.037). In particular, exposure to noncardioselective β-blocker before septic episode was associated with decreased mortality. Sequential Organ Failure Assessment score analysis showed that premorbid β-blocker exposure had potential benefits in reducing respiratory and neurologic dysfunction. Conclusions This study suggests that β-blocker exposure prior to sepsis, especially to noncardioselective β blockers, may be associated with better outcome. The findings suggest prospective evaluation of β-blocker use in the management of sepsis. |
| Databáze: | OpenAIRE |
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