Outpatient beta-blockers and survival from sepsis: Results from a national cohort of Medicare beneficiaries

Am J Surg. 2017 Oct;214(4):577-582. doi: 10.1016/j.amjsurg.2017.06.007. Epub 2017 Jun 24.

Abstract

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.

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use*
  • Aged
  • Aged, 80 and over
  • Demography
  • Female
  • Hospital Mortality
  • Humans
  • Male
  • Medicare*
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Sepsis / mortality*
  • Survival Rate
  • United States / epidemiology

Substances

  • Adrenergic beta-Antagonists