Effect of β-blockers on mortality in patients with sepsis: A propensity-score matched analysis

Cheng-Long Ge; Li-Na Zhang; Yu-Hang Ai; Wei Chen; Zhi-Wen Ye; Yu Zou; Qian-Yi Peng

doi:10.3389/fcimb.2023.1121444

Effect of β-blockers on mortality in patients with sepsis: A propensity-score matched analysis

Front Cell Infect Microbiol. 2023 Mar 28:13:1121444. doi: 10.3389/fcimb.2023.1121444. eCollection 2023.

Authors

Cheng-Long Ge^{1

2

3}, Li-Na Zhang^{1

2

3}, Yu-Hang Ai^{1

2

3}, Wei Chen^{1

2

3}, Zhi-Wen Ye^{1

2

3}, Yu Zou⁴, Qian-Yi Peng^{1

2

3}

Affiliations

¹ Department of Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China.
² National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China.
³ Hunan Provincial Clinical Research Center for Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China.
⁴ Department of Anesthesia, Xiangya Hospital, Central South University, Changsha, Hunan, China.

Abstract

Objectives: We aimed to evaluate the association between β-blocker therapy and mortality in patients with sepsis.

Methods: Patients with sepsis were selected from the Medical Information Mart for Intensive Care (MIMIC)-III. Propensity score matching (PSM) was used to balance the baseline differences. A multivariate Cox regression model was used to assess the relationship between β-blocker therapy and mortality. The primary outcome was the 28-day mortality.

Results: A total of 12,360 patients were included in the study, involving 3,895 who received β-blocker therapy and 8,465 who did not. After PSM, 3,891 pairs of patients were matched. The results showed that β-blockers were associated with improved 28- (hazards ratio (HR) 0.78) and 90-day (HR 0.84) mortality. Long-acting β-blockers were associated with improved 28-day survival (757/3627 [20.9%] vs. 583/3627 [16.1%], P < 0.001, HR0.76) and 90-day survival (1065/3627 [29.4%] vs.921/3627 [25.4%], P < 0.001, HR 0.77). Short-acting β-blocker treatment did not reduce the 28-day and 90-day mortality (61/264 [23.1%] vs. 63/264 [23.9%], P = 0.89 and 83/264 [31.4%] vs. 89/264 [31.7%], P = 0.8, respectively).

Conclusions: β-blockers were associated with improved 28- and 90-day mortality in patients with sepsis and septic shock. Long-acting β-blocker therapy may have a protective role in patients with sepsis, reducing the 28-day and 90-day mortality. However, short-acting β-blocker (esmolol) treatment did not reduce the mortality in sepsis.

Keywords: MIMIC; mortality; propensity score matching; sepsis; β-blockers.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adrenergic beta-Antagonists / therapeutic use
Humans
Propensity Score
Retrospective Studies
Sepsis* / drug therapy
Shock, Septic* / drug therapy

Substances

Adrenergic beta-Antagonists

Grants and funding

This work was supported by the National Natural Science Foundation of China (81974285), the National Natural Science Foundation of China (81901264), the Natural Science Foundation of Hunan Province (2020JJ5918), the Natural Science Foundation of Hunan Province (2020JJ5959) China, and the National Natural Science Foundation of China (82172145).