tailieunhanh - Báo cáo y học: "Preadmission beta-blocker use and 30-day mortality among patients in intensive care: a cohort study"

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 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 95 confidence interval CI to for beta-blocker users compared with non-users. In the propensity score-matched analysis we matched all 1 556 beta-blocker users of the entire cohort with 1 556 non-users the 30-day mortality was among beta-blocker users and among non-users OR 95 CI to . The OR was 95 CI to for surgical ICU patients and 95 CI to for medical ICU patients. The OR was 95 CI to among users of non-selective beta-blockers and 95 CI to among users of cardioselective beta-blockers. Conclusions Preadmission beta-blocker use is associated with