Kamath A, Stover D E, Hemdan A, Belinskaya I, Steingart R M, Taur Y, Feinstein M B
Long Island Pulmonary and Sleep Associates, 200 North Village Avenues, Suite 300, Rockville Centre, NY 11750-5294, USA ; Primary Research Institution, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021-9809, USA.
Primary Research Institution, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021-9809, USA.
Lung Cancer Int. 2015;2015:204826. doi: 10.1155/2015/204826. Epub 2015 Sep 1.
The aim of this study is to determine if COPD patients undergoing lung resection with perioperative β-blocker use are more likely to suffer postoperative COPD exacerbations than those that did not receive perioperative β-blockers. Methods. A historical cohort study of COPD patients, undergoing lung resection surgery at Memorial Sloan-Kettering Cancer Center between 2002 and 2006. Primary outcomes were the rate of postoperative COPD exacerbations, defined as any initiation or increase of glucocorticoids for documented bronchospasm. Results. 520 patients with COPD were identified who underwent lung resection. Of these, 205 (39%) received perioperative β-blockers and 315 (61%) did not. COPD was mild among 361 patients (69% of all patients), moderate in 117 patients (23%), and severe in 42 patients (8%). COPD exacerbations occurred among 11 (5.4%) patients who received perioperative β-blockers and among 20 (6.3%) patients who did not. Secondary outcomes, which included respiratory failure, 30-day mortality, and the presence or absence of any cardiovascular complication, ICU transfer, cardiovascular complication, or readmission within 30 days, did not differ in prevalence between the two groups. Conclusions. This study implies that perioperative β-blockers use among COPD patients undergoing lung resection surgery does not impact the rate of exacerbations.
本研究的目的是确定在接受肺切除术时使用围手术期β受体阻滞剂的慢性阻塞性肺疾病(COPD)患者是否比未接受围手术期β受体阻滞剂的患者更易发生术后COPD急性加重。方法。对2002年至2006年期间在纪念斯隆凯特琳癌症中心接受肺切除手术的COPD患者进行一项历史性队列研究。主要结局是术后COPD急性加重率,定义为因记录在案的支气管痉挛而开始使用或增加糖皮质激素的情况。结果。确定了520例接受肺切除术的COPD患者。其中,205例(39%)接受了围手术期β受体阻滞剂治疗,315例(61%)未接受。361例患者(占所有患者的69%)的COPD为轻度,117例患者(23%)为中度,42例患者(8%)为重度。接受围手术期β受体阻滞剂治疗的11例(5.4%)患者和未接受治疗的20例(6.3%)患者发生了COPD急性加重。次要结局包括呼吸衰竭、30天死亡率以及是否存在任何心血管并发症、重症监护病房(ICU)转入、心血管并发症或30天内再次入院,两组之间的患病率无差异。结论。本研究表明,在接受肺切除手术的COPD患者中使用围手术期β受体阻滞剂不会影响急性加重率。