Duration of Preoperative β-Blockade and Outcomes After Major Elective Noncardiac Surgery
Key result
Initiation of β-blocker therapy 1-7 days before noncardiac surgery was associated with increased 30-day mortality compared with ≥31 days of therapy (OR 1.49; 95% CI 1.03-2.16; P=0.03).
Why the study?
Does a shorter duration of preoperative β-blocker treatment (1-30 days) increase mortality and cardiovascular events compared to ≥31 days in older patients undergoing major elective noncardiac surgery?
Population
48,103 patients aged ≥ 66 years who underwent major elective noncardiac surgery and received preoperative…
Comparison
Preoperative β-blocker treatment for 1-7 days or… vs Preoperative β-blocker treatment for ≥ 31 days
Design
Cohort
Follow-up
1 year
Authors
Discussion
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Member takes
Implication
Supports caution with β-blocker initiation <1 week before noncardiac surgery; leaves open optimal preoperative duration pending randomized data.
Study Design
Type
Cohort (n=48,103)
Structured PICO
Does a shorter duration of preoperative β-blocker treatment (1-30 days) increase mortality and cardiovascular events compared to ≥31 days in older patients undergoing major elective noncardiac surgery?
P
Population
48,103 patients aged ≥ 66 years undergoing major elective noncardiac surgery who received preoperative β-blocker therapy.
E
Exposure
Preoperative β-blocker treatment for 1-7 days or 8-30 days
C
Comparator
Preoperative β-blocker treatment for ≥ 31 days
O
Outcome
30-day mortality, 30-day myocardial infarction (MI), 30-day ischemic stroke, and 1-year mortalityhard clinical
Main Result
Odds Ratio: 1.49 (95% CI 1.03–2.16)
p-value: p=0.03
Initiating β-blocker therapy only 1-7 days before major noncardiac surgery is associated with increased 30-day mortality compared to starting it ≥31 days prior.
Cite This Study
Wijeysundera et al. (2013) conducted a cohort in Major elective noncardiac surgery (n=48,103). 1-7 days of preoperative β-blocker therapy vs. ≥ 31 days of preoperative β-blocker therapy was evaluated on 30-day mortality (OR 1.49, 95% CI 1.03-2.16, p=0.03). Initiation of β-blocker therapy 1-7 days before noncardiac surgery was associated with increased 30-day mortality compared with ≥31 days of therapy (OR 1.49; 95% CI 1.03-2.16; P=0.03).