Outpatient beta-blockers and survival from sepsis: Results from a national cohort of Medicare beneficiaries
Department of Surgery; Department of Quantitative Health Sciences; School of Medicine; Senior Scholars Program
Bacterial Infections and Mycoses | Geriatrics | Medical Education | Pathological Conditions, Signs and Symptoms | Surgery
BACKGROUND: Elderly Americans suffer increased mortality from sepsis. Given that beta-blockers have been shown to be cardioprotective in critical care, we investigated outpatient beta-blocker prescriptions and mortality among Medicare beneficiaries admitted for sepsis.
METHODS: We queried a 5% random sample of Medicare beneficiaries for patients admitted with sepsis. We used in-hospital and outpatient prescription drug claims to compare in-hospital and 30-day mortality based on pre-admission beta-blocker prescription and class of beta-blocker prescribed using univariate tests of comparison and multivariable logistic regression models and another class of medications for control.
RESULTS: Outpatient beta-blocker prescription was associated with a statistically significant decrease in in-hospital and 30-day mortality. In multivariable modeling, beta-blocker prescription was associated with 31% decrease in in-hospital mortality and 41% decrease in 30-day mortality. Both cardioselective and non-selective beta-blockers conferred mortality benefit.
CONCLUSIONS: Our data suggests that there may be a role for preadmission beta-blockers in reducing sepsis-related mortality.
DOI of Published Version
Am J Surg. 2017 Oct;214(4):577-582. doi: 10.1016/j.amjsurg.2017.06.007. Epub 2017 Jun 24. Link to article on publisher's site
American journal of surgery
Singer, Kathleen E.; Collins, Courtney E.; Flahive, Julie; Wyman, Allison; Ayturk, M. Didem; and Santry, Heena, "Outpatient beta-blockers and survival from sepsis: Results from a national cohort of Medicare beneficiaries" (2017). University of Massachusetts Medical School. Senior Scholars Program. Paper 265.