A nationwide observational cohort study of the relationship between beta-blockade and survival after hip fracture surgery

• DOI: 10.1007/s00068-020-01588-7
• Publication Date: 2021-01-28T14:08:15Z
• Authors: Rebecka Ahl; Ahmad Mohammad Is...; Tomas Borg; Gabriel Sjölin; Maximilian Peter ...; Yang Cao; Per Wretenberg; Shahin Mohseni
• Keywords: Sports medicine; Hip Fracture

Abstract Purpose Despite advances in the care of hip fractures, this area surgery is associated with high postoperative mortality. Downregulating circulating catecholamines, released as a response to traumatic injury and surgical trauma, believed reduce risk death noncardiac patients. This effect has not been studied fractures. study aims assess whether survival benefits are gained by reducing effects hyper-adrenergic state beta-blocker therapy patients undergoing emergency fracture surgery. Methods retrospective nationwide observational cohort study. All adults $$\ge$$ <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"> <mml:mo>≥</mml:mo> </mml:math> 18 years were identified from prospectively collected national quality register for fractures Sweden during 10-year period. Pathological excluded. The was subdivided into users non-users. Poisson regression robust standard errors adjustments confounders used evaluate 30-day Results 134,915 included whom 38.9% had ongoing at time Beta-blocker significantly older less fit Crude all-cause mortality increased non-users (10.0% versus 3.7%, p &lt; 0.001). resulted 72% relative reduction (incidence rate ratio 0.28, 95% CI 0.26–0.29, 0.001) independently deaths cardiovascular, respiratory, cerebrovascular origin due sepsis or multiorgan failure. Conclusions Beta-blockers significant when Outlined results strongly encourage an interventional design validate observed relationship.