Long-term β-blocker therapy was associated with reduced 30-day mortality in sepsis patients with absolute tachycardia (OR 0.406; 95% CI 0.177-0.932).
Cohort (n=1,186)
No
Does long-term beta-blocker therapy reduce 30-day all-cause mortality in adult patients hospitalized with sepsis?
Long-term beta-blocker therapy is associated with reduced 30-day mortality in patients hospitalized with sepsis who exhibit absolute or relative tachycardia.
Odds Ratio: 0.406 (95% CI 0.177–0.932)
BACKGROUND: Sepsis is associated with excessive release of catecholamines, which causes tachycardia and is correlated with poor clinical outcome. β-Blockers (BBs) may blunt this effect on heart rate (HR). The objective of this study is to assess whether long-term BB therapy is associated with better clinical outcomes in patients with sepsis admitted to internal medicine wards. METHODS: We performed a single-center, observational cohort study. We included adult patients who were hospitalized in medicine departments due to sepsis. A propensity score model for BB therapy was used to match patients. The primary outcome was the 30-day all-cause mortality rate. A multivariate analysis was performed to identify risk factors for an adverse outcome. Patients were stratified according to absolute tachycardia (HR ≥100/min) or relative tachycardia at presentation (tachycardia index above the third quartile, with tachycardia index defined as the ratio of HR to temperature). RESULTS: A total of 1186 patients fulfilled the inclusion criteria. In the propensity-matched cohort patients given BB treatment were younger (median age interquartile range, 74 62-82 vs 81 68-87 years; P ≤ .001). BB treatment was associated with reduction in 30-day mortality rates for patients with absolute tachycardia (odds ratio, 0.406; 95% confidence interval, .177-.932). Final model with interaction variable of BB treatment with HR was associated with short-term survival (odds ratio, 0.38; 95% confidence interval, .148-.976). Selective BB therapy had a stronger protective effect than nonselective BB therapy. CONCLUSIONS: Long-term BB therapy was associated with decreased mortality rate in patients hospitalized with sepsis in internal medicine wards exhibiting absolute and relative tachycardia.
Guz et al. (Fri,) conducted a cohort in Sepsis (n=1,186). Long-term β-Blocker therapy vs. No β-Blocker therapy was evaluated on 30-day all-cause mortality rate (OR 0.406, 95% CI 0.177-0.932). Long-term β-blocker therapy was associated with reduced 30-day mortality in sepsis patients with absolute tachycardia (OR 0.406; 95% CI 0.177-0.932).