Prior beta-blocker treatment improves outcomes in out-of-hospital cardiac arrest patients with non-shockable rhythms
| Autor: | Wen-Jone Chen, Hui-Chun Huang, Ping-Hsun Yu, Kuo-Liong Chien, Min-Shan Tsai, Chien-Hua Huang |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty medicine.drug_class Science Adrenergic beta-Antagonists Population Electric Countershock Medication prescription Article Internal medicine medicine Humans Propensity Score education Carvedilol Beta blocker Aged education.field_of_study Multidisciplinary business.industry Retrospective cohort study Odds ratio medicine.disease Survival Analysis Logistic Models Treatment Outcome Outcomes research Heart failure Multivariate Analysis Propensity score matching Cardiology Medicine Female business Interventional cardiology Out-of-Hospital Cardiac Arrest medicine.drug |
| Zdroj: | Scientific Reports, Vol 11, Iss 1, Pp 1-10 (2021) Scientific Reports |
| ISSN: | 2045-2322 |
| DOI: | 10.1038/s41598-021-96070-8 |
| Popis: | The prognosis of out of cardiac arrest is poor and most cardiac arrest patients suffered from the non-shockable rhythm especially in patients without pre-existing cardiovascular diseases and medication prescription. Beta-blocker (ß-blocker) therapy has been shown to improve outcomes in cardiovascular diseases such as heart failure, ischemia related cardiac, and brain injuries. Therefore, we investigated whether prior ß-blockers use was associated with reduced mortality in patients with cardiac arrest and non-shockable rhythm. We conducted a population-based retrospective cohort study using multivariate propensity score–based regression to control for differences among patients with cardiac arrest. A total of 104,568 adult patients suffering a non-traumatic and non-shockable rhythm cardiac arrest between 2005 and 2011 were identified. ß-blocker prescription at least 30 days prior to the cardiac arrest event was defines as the ß-blockers group. We chose 12.5 mg carvedilol as the cut-off value and defined greater or equal to carvedilol 12.5 mg per day and its equivalent dose as high-dose group. After multivariate propensity score–based logistic regression analysis, patients with prior ß-blockers use were associated with better 1-year survival [adjusted odds ratio (OR), 1.15, 95% confidence interval (CI) 1.01–1.30; P = 0.031]. Compared to non-ß-blocker use group and prior low-dose ß-blockers use group, prior high-dose ß-blockers use group was associated with higher mechanical ventilator wean success rate (adjusted OR 1.19, 95% CI 1.01–1.41, P = 0.042). In conclusion, prior high dose ß-blockers use was associated with a better 1-year survival and higher weaning rate in patients with non-shockable cardiac arrest. |
| Databáze: | OpenAIRE |
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