Effect of beta-blockers on perioperative outcomes in vascular and endovascular surgery: a systematic review and meta-analysis
| Autor: | S, Hajibandeh, S A, Antoniou, F, Torella, G A, Antoniou |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Adrenergic beta-Antagonists 030204 cardiovascular system & hematology Perioperative Care law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial 030202 anesthesiology law Internal medicine medicine Humans Prospective Studies Myocardial infarction Prospective cohort study Retrospective Studies business.industry Endovascular Procedures Retrospective cohort study Perioperative Odds ratio Vascular surgery medicine.disease Surgery Anesthesiology and Pain Medicine Meta-analysis Cardiology and Cardiovascular Medicine business Vascular Surgical Procedures |
| Zdroj: | British Journal of Anaesthesia. 118:11-21 |
| ISSN: | 0007-0912 |
| DOI: | 10.1093/bja/aew380 |
| Popis: | Background To investigate the role of perioperative beta-blocker use in vascular and endovascular surgery. Methods We performed a systematic review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement standards. The review protocol was registered with International Prospective Register of Systematic Reviews (registration number:CRD42016038111). We searched electronic databases to identify all randomized controlled trials and observational studies investigating outcomes of patients undergoing vascular and endovascular surgery with or without perioperative beta blockade. We used the Cochrane tool and the Newcastle-Ottawa scale to assess the risk of bias of trials and observational studies, respectively. Random-effects models were applied to calculate pooled outcome data. Results We identified three randomized trials, five retrospective cohort studies, and three prospective cohort studies, enrolling a total of 32,602 patients. Our analyses indicated that perioperative use of beta-blockers did not reduce the risk of all-cause mortality [odds ratio (OR) 1.10, 95% confidence interval (CI) 0.59-2.04, P = 0.77], cardiac mortality (OR 2.62, 95% CI 0.86-8.05, P = 0.09), myocardial infarction (OR 0.89, 95% CI 0.59-1.35, P = 0.58), unstable angina (OR 1.34, 95% CI 0.41- 4.38, P = 0.63), stroke (OR 2.45, 95% CI 0.89-6.75, P = 0.08), arrhythmias (OR 0.76, 95% CI 0.41-1.43, P = 0.40), congestive heart failure (OR 1.12, 95% CI 0.77-1.63, P = 0.56), renal failure (OR 1.48, 95% CI 0.90-2.45, P = 0.13), composite cardiovascular events (OR 0.88, 95% CI 0.55-1.40, P = 0.58), rehospitalisation (OR 0.86, 95% CI 0.48-1.52, P = 0.60), and reoperation (OR 1.17, 95% CI 0.42-3.27, P = 0.77) in vascular surgery. Conclusions Beta-blockers do not improve perioperative outcomes in vascular and endovascular surgery. |
| Databáze: | OpenAIRE |
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