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. 2019 Sep 4;23(1):298.
doi: 10.1186/s13054-019-2562-y.

The association between premorbid beta blocker exposure and mortality in sepsis-a systematic review

Kaiquan Tan  1 , Martin Harazim  2 , Benjamin Tang  1   3 , Anthony Mclean  1   4 , Marek Nalos  5   6   7
Affiliations

The association between premorbid beta blocker exposure and mortality in sepsis-a systematic review

Kaiquan Tan et al. Crit Care. .

Erratum in

Abstract

Background: The effect of premorbid β-blocker exposure on clinical outcomes in patients with sepsis is not well characterized. We aimed to examine the association between premorbid β-blocker exposure and mortality in sepsis.

Methods: EMBase, MEDLINE, and Cochrane databases were searched for all studies of premorbid β-blocker and sepsis. The search was last updated on 22 June 2019. Two reviewers independently assessed, selected, and abstracted data from studies reporting chronic β-blocker use prior to sepsis and mortality. Main data extracted were premorbid β-blocker exposure, mortality, study design, and patient data. Two reviewers independently assessed the risk of bias and quality of evidence.

Results: In total, nine studies comprising 56,414 patients with sepsis including 6576 patients with premorbid exposure to β-blockers were eligible. For the primary outcome of mortality, two retrospective studies reported adjusted odds ratios showing a reduction in mortality with premorbid β-blocker exposure. One study showed that premorbid β-blocker exposure decreases mortality in patients with septic shock. Another study showed that continued β-blockade during sepsis is associated with decreased mortality.

Conclusion: This systematic review suggests that β-blocker exposure prior to sepsis is associated with reduced mortality. There was insufficient data to conduct a bona fide meta-analysis. Whether the apparent reduction in mortality may be attributed to the mitigation of catecholamine excess is unclear.

Trial registration: PROSPERO, CRD42019130558 registered June 12, 2019.

Keywords: Beta blockers; Mortality; Sepsis; Systematic review.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of the study selection process
Fig. 2
Fig. 2
Adjusted odds ratio analysis via forest plot of sepsis mortality rates in studies comparing populations with premorbid β-blocker (BB) exposure to populations without premorbid β-blocker exposure. Horizontal bars represent 95% confidence intervals
See this image and copyright information in PMC

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