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Open Access 01-12-2019 | ß-Blockers | Research

The association between premorbid beta blocker exposure and mortality in sepsis—a systematic review

Authors: Kaiquan Tan, Martin Harazim, Benjamin Tang, Anthony Mclean, Marek Nalos

Published in: Critical Care | Issue 1/2019

Abstract

Background

The effect of premorbid β-blocker exposure on clinical outcomes in patients with sepsis is not well characterized. We aimed to examine the association between premorbid β-blocker exposure and mortality in sepsis.

Methods

EMBase, MEDLINE, and Cochrane databases were searched for all studies of premorbid β-blocker and sepsis. The search was last updated on 22 June 2019. Two reviewers independently assessed, selected, and abstracted data from studies reporting chronic β-blocker use prior to sepsis and mortality. Main data extracted were premorbid β-blocker exposure, mortality, study design, and patient data. Two reviewers independently assessed the risk of bias and quality of evidence.

Results

In total, nine studies comprising 56,414 patients with sepsis including 6576 patients with premorbid exposure to β-blockers were eligible. For the primary outcome of mortality, two retrospective studies reported adjusted odds ratios showing a reduction in mortality with premorbid β-blocker exposure. One study showed that premorbid β-blocker exposure decreases mortality in patients with septic shock. Another study showed that continued β-blockade during sepsis is associated with decreased mortality.

Conclusion

This systematic review suggests that β-blocker exposure prior to sepsis is associated with reduced mortality. There was insufficient data to conduct a bona fide meta-analysis. Whether the apparent reduction in mortality may be attributed to the mitigation of catecholamine excess is unclear.

Trial registration

PROSPERO, CRD42019130558 registered June 12, 2019.

Available only for authorised users

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Title: The association between premorbid beta blocker exposure and mortality in sepsis—a systematic review
Authors: Kaiquan Tan
Martin Harazim
Benjamin Tang
Anthony Mclean
Marek Nalos
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: ß-Blockers
Septicemia
Septicemia
Septic Shock
Published in: Critical Care / Issue 1/2019
Electronic ISSN: 1364-8535
DOI: https://doi.org/10.1186/s13054-019-2562-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The association between premorbid beta blocker exposure and mortality in sepsis—a systematic review

Abstract

Background

Methods

Results

Conclusion

Trial registration

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Trial registration

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