British Journal of Anaesthesia, 2003, Vol. 90, No. 1 27-31
© 2003 The Board of Management and Trustees of the British Journal of Anaesthesia
Clinical Investigations |
Effect of preoperative ß-blockade on perioperative mortality in coronary surgery
Department of Anaesthesia, University Hospital Antwerp, Wilrijkstraat 10, B-2650 Edegem, Belgium E-mail: pietertenbroeke@hotmail.com
Background. Many preoperative factors can influence perioperative mortality in cardiac surgery. Because the perioperative use of ß-blocking agents may reduce perioperative cardiac complications in non-cardiac surgery, we considered the possibility that ß-blocking agents could improve survival in coronary surgery patients.
Methods. In a retrospective study on 1586 patients undergoing coronary bypass surgery, the relative risk of 30-day mortality was determined in relation to preoperative risk factors and medication. Factors included patient characteristics, pre-existing illness, specific cardiovascular risk factors, cardiac status and urgency of surgery. Treatment with ß-blocking agents, calcium antagonists, angiotensin-converting enzyme inhibitors, nitrates, anti-arrhythmic agents, diuretics and antithrombotic agents was taken into account.
Results. Sex, age, chronic obstructive pulmonary disease, urgency and the preoperative use of diuretics and chronic ß-blocking therapy were found to be linked to mortality (P<0.05). Backward stepwise regression testing identified age, urgency and ß-blocking therapy as independent factors that could predict mortality.
Conclusions. Increasing age and urgency of surgery are associated with greater mortality, whereas preoperative ß-blocking therapy is associated with less mortality. The characteristics of patients who received chronic ß-blockade did not differ significantly from those of patients who did not. The results suggest that chronic preoperative ß-blocker therapy reduces 30-day mortality in coronary surgery.
Br J Anaesth 2003; 90: 27–31
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