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Báo cáo y học: "Preadmission beta-blocker use and 30-day mortality among patients in intensive care: a cohort study"
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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Preadmission beta-blocker use and 30-day mortality among patients in intensive care: a cohort study. | Christensen et al. Critical Care 2011 15 R87 http ccforum.eom content 15 2 R87 KS CRITICAL CARE RESEARCH Open Access Preadmission beta-blocker use and 30-day mortality among patients in intensive care a cohort study Steffen Christensen1 2 Martin Berg Johansen1 Else Tonnesen2 Anders Larsson3 Lars Pedersen1 Stanley Lemeshow4 and Henrik Toft Sorensen1 Abstract Introduction Beta-blockers have cardioprotective metabolic and immunomodulating effects that may be beneficial to patients in intensive care. We examined the association between preadmission beta-blocker use and 30-day mortality following intensive care. Methods We identified 8 087 patients over age 45 admitted to one of three multidisciplinary intensive care units ICUs between 1999 and 2005. Data on the use of beta-blockers and medications diagnosis comorbidities surgery markers of socioeconomic status laboratory tests upon ICU admission and complete follow-up for mortality were obtained from medical databases. We computed probability of death within 30 days following ICU admission for beta-blocker users and non-users and the odds ratio OR of death as a measure of relative risk using conditional logistic regression and also did a propensity score-matched analysis. Results Inclusion of all 8 087 ICU patients in a logistic regression analysis yielded an adjusted OR of 0.82 95 confidence interval CI 0.71 to 0.94 for beta-blocker users compared with non-users. In the propensity score-matched analysis we matched all 1 556 beta-blocker users 19.2 of the entire cohort with 1 556 non-users the 30-day mortality was 25.7 among beta-blocker users and 31.4 among non-users OR 0.74 95 CI 0.63 to 0.87 . The OR was 0.69 95 CI 0.54 to 0.88 for surgical ICU patients and 0.71 95 CI 0.51 to 0.98 for medical ICU patients. The OR was 0.99 95 CI 0.67 to 1.47 among users of non-selective beta-blockers and 0.70 95 CI 0.58 to 0.83 among users of cardioselective beta-blockers. Conclusions Preadmission beta-blocker use is associated with