Patterns of β-blocker initiation in patients undergoing intermediate to high-risk noncardiac surgery.
Patterns of β-blocker initiation in patients undergoing intermediate to high-risk noncardiac surgery.
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DOI：
10.1016/j.ahj.2015.06.028
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发表时间：
2015-10
影响因子：
4.8
通讯作者：
Bateman BT
中科院分区：
文献类型：
--
作者：
Patorno E;Wang SV;Schneeweiss S;Liu J;Bateman BT
Based on 2 small randomized controlled trials (RCTs) from the 1990s, β-blockers were promoted to prevent perioperative cardiac events in patients undergoing noncardiac surgery. In 2008, a large RCT (POISE trial) showed an increased mortality risk associated with perioperative β-blockade, raising concerns about an extensive β-Blocker use. The objective of the study is to examine patterns of β-Blocker initiation among patients undergoing noncardiac elective surgery in the US. From a large, nationwide US health care insurer, we identified patients ≥18 years old who underwent moderate- to high-risk noncardiac elective surgery between 2003 and 2012 and initiated a β-Blocker within 30 days before surgery. We evaluated temporal trends and assessed the impact of the POISE trial on perioperative β-Blocker initiation. We also evaluated patient characteristics and examined the effect of temporal proximity to surgery on the likelihood of β-Blocker initiation. Of 499,752 patients undergoing surgery, 9,014 (18 per 1,000 patients) initiated a β-Blocker. β-Blocker initiation increased from 12 per 1,000 patients in 2003 to 23 before POISE, after which it decreased to 14 by December 2012 (P = .0001). β-Blocker initiation remained relatively high among patients undergoing vascular surgery or with Revised Cardiac Risk Index score ≥2. Proximity to surgery was highly predictive of β-Blocker initiation (odds ratio 3.34, 95% CI 3.17-3.51). After a period of a rapidly increasing trend, perioperative β-Blocker initiation decreased sharply in the second half of 2008 and continued to decrease afterwards. β-Blocker initiation remained relatively high in patients with Revised Cardiac Risk Index score ≥2 and in those undergoing major vascular surgery.
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DOI：
10.1136/heartjnl-2013-304262
发表时间：
2014-03
期刊：
Heart (British Cardiac Society)
影响因子：
--
作者：
Bouri S;Shun-Shin MJ;Cole GD;Mayet J;Francis DP
通讯作者：
Francis DP
DOI：
10.1046/j.1365-2710.2002.00430.x
发表时间：
2002-08-01
影响因子：
2
作者：
Wagner, AK;Soumerai, SB;Ross-Degnan, D
通讯作者：
Ross-Degnan, D
影响因子：
37.8
作者：
Eagle, KA;Berger, PB;Smith, SC
通讯作者：
Smith, SC
影响因子：
4.8
作者：
Yang, Homer;Raymer, Karen;Roberts, Robin
通讯作者：
Roberts, Robin
影响因子：
120.7
作者：
London, Martin J.;Hur, Kwan;Henderson, William G.
通讯作者：
Henderson, William G.