Association between the use of β-adrenergic receptor blockers and all-cause mortality in sepsis-associated rhabdomyolysis syndrome: a cohort study

Background To assess the association between the use of β-blockers and all-cause mortality in Sepsis-associated Rhabdomyolysis (SAR). Methods This retrospective cohort study involves adults with SAR. Study variables were extracted from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database. Propensity score matching (PSM) was conducted at a 1:1 ratio to analyze the association between the use of β-blockers and in-hospital mortality in SAR. Multivariable analysis was employed to adjust for confounding factors, while sensitivity analysis and subgroup analysis were conducted to demonstrate the robustness of the results. Results This study involved pre-matched and propensity score-matched cohorts comprising 1,194 and 584 patients, respectively. Through propensity score matching (PSM) analysis, this study observed a notable difference in in-hospital mortality rates. Importantly, the utilization of β-blockers was found to be significantly associated with lower in-hospital all-cause mortality. Furthermore, sensitivity analyses conducted on the entire cohort, as well as cohorts excluding patients with specific comorbidities, consistently demonstrated a significant association between β-blocker usage and lower in-hospital mortality. Subgroup analyses further underscored the robustness of the findings. Conclusions The use of β-blockers was associated with lower mortality in patients with SAR. However, prospective studies are needed to validate this finding.