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30 September 2009

Effect of beta blockers on sepsis outcome

Jose GutierrezABDEFG, Amin HossamA, Roxana LazarezcuB, El KayB, Tatjana RundekCDE

Med Sci Monit 2009; 15(10): CR499-503 :: ID: 878210

Abstract

Background
The aim of this study was to investigate weather beta blockers are associated with an increased mortality in sepsis.
Material and Method
Data on 83 patients with sepsis treated in ICU were analyzed from the retrospective chart review. The association between treatment with Beta blockers and mortality was analyzed by logistic regression in univariate model and after adjusting for the APACHE morbidity/ mortality scores.
Results
Among 83 patients (mean age 56.2+/-17.3 years, female 51%, the mean APACHE score 74.8+/-23.3), 29 were treated with BB. Those treated with BB had APACHE score of 79.93+/-23.47 and those not treated with BB had APACHE score of 73.67+/-23.21. No significant difference between the traditional cardiovascular risk factors was found in both groups except for HTN. Treatment with BB was not significantly associated with mortality in the univariate (OR=1.83, 95% CI 0.59-5.69) nor multivariate model (OR=1.843, 95% CI 0.56-6.10). The APACHE score was a strong predictor of mortality (OR=1.04, 95% CI 1.01-1.06, p=0.02). This association was independent of BB use, and no significant interaction (p=0.72) between BB and APACHE score was observed.
Conclusions
We did not show a significant association between beta blockers and increased mortality in patients with sepsis. Sicker patients had an increase risk of death, and possibility that beta blocker use may have contributed to this risk cannot be completely ruled out. Our study was limited by a small sample size and retrospective design. Further investigations of potential benefits and side effect of beta blockers in patients with sepsis are warranted.

Keywords: Sepsis - drug therapy, Lactic Acid - blood, Aged, 80 and over, Adrenergic beta-Antagonists - therapeutic use, APACHE, young adult

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Medical Science Monitor eISSN: 1643-3750