Effect of Preoperative Beta-Blocker Use on Outcomes Following Cardiac Surgery.

ABSTRACT: Recent studies suggest that the use of preoperative ? blockers in cardiac surgery may not provide improved mortality rates and may even contribute to negative clinical outcomes. We therefore assessed the role of ? blockers on several outcomes after cardiac surgery (delirium, acute kidney injury [AKI], stroke, atrial fibrillation (AF), mortality, and hospital length of stay) in 4,076 patients who underwent elective coronary artery bypass grafting, coronary artery bypass grafting?+?valve, or valve cardiac surgery from November 1, 2009, to September 30, 2015, at Vanderbilt Medical Center. Clinical data from 2 prospectively collected datasets at our institution were reviewed: the Cardiac Surgery Perioperative Outcomes Database and the Society of Thoracic Surgeons Database. Preoperative ?-blocker use was defined by Society of Thoracic Surgeons guidelines as patients receiving a ? blocker within 24 hours preceding surgery. Of the included patients, 2,648 (65.0%) were administered a ? blocker within 24 hours before surgery. Adjusting for possible confounders, preoperative ?-blocker use was associated with increased odds of AKI stage 2 (odds ratio 1.96, 95% confidence interval 1.19 to 3.24, p?<0.01). There was no evidence that ?-blocker use had an independent association with postoperative delirium, AKI stages 1 and 3, stroke, AF, mortality, or prolonged length of stay. A secondary propensity score analysis did not show a marginal association between ?-blocker use and any outcome. In conclusion, we did not find significant evidence that preoperative ?-blocker use was associated with postoperative delirium, AF, AKI, stroke, or mortality.

SUBMITTER: O'Neal JB 

PROVIDER: S-EPMC5675103 | biostudies-literature | 2017 Oct

REPOSITORIES: biostudies-literature