Table_8_Effect of β-blockers on mortality in patients with sepsis: A propensity-score matched analysis.docx

ObjectivesWe aimed to evaluate the association between β-blocker therapy and mortality in patients with sepsis.MethodsPatients 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.ResultsA 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).Conclusionsβ-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.

本研究旨在评估β-受体阻滞剂治疗与败血症患者死亡率之间的关联。研究方法中，研究人员从重症监护医学信息市场（MIMIC-III）中选取了败血症患者。通过倾向评分匹配（PSM）技术来均衡基线差异。采用多变量Cox回归模型来评估β-受体阻滞剂治疗与死亡率之间的关系。主要观察指标为28天死亡率。研究结果显示，共纳入12,360名患者，其中3,895名接受了β-受体阻滞剂治疗，而8,465名未接受治疗。经过PSM匹配后，共获得3,891对匹配的患者。研究结果表明，β-受体阻滞剂与28天（风险比（HR）0.78）和90天（HR 0.84）死亡率的降低相关。长效β-受体阻滞剂与28天生存率的提高相关（757/3627 [20.9%] vs. 583/3627 [16.1%]，P < 0.001，HR 0.76），以及90天生存率的提高（1065/3627 [29.4%] vs. 921/3627 [25.4%]，P < 0.001，HR 0.77）。短效β-受体阻滞剂治疗并未降低28天和90天的死亡率（61/264 [23.1%] vs. 63/264 [23.9%]，P = 0.89 和 83/264 [31.4%] vs. 89/264 [31.7%]，P = 0.8，分别）。结论指出，β-受体阻滞剂与败血症和败血症休克患者的28天和90天死亡率降低相关。长效β-受体阻滞剂治疗可能在败血症患者中发挥保护作用，降低28天和90天的死亡率。然而，短效β-受体阻滞剂（如艾斯莫洛尔）治疗并未降低败血症患者的死亡率。