病前使用β受体阻滞剂对脓毒症患者死亡率的影响：一项系统评价和荟萃分析
Effect of Premorbid Beta-Blockers on Mortality in Patients With Sepsis: A Systematic Review and Meta-Analysis.
作者信息
Hasegawa Daisuke, Sato Ryota, Prasitlumkum Narut, Nishida Kazuki
机构信息
22524Mount Sinai Beth Israel, NY, USA.
Anesthesiology and Critical Care Medicine, 2569Fujita Health University School of Medicine, Toyoake, Japan.
出版信息
J Intensive Care Med. 2022 Jul;37(7):908-916. doi: 10.1177/08850666211052926. Epub 2021 Nov 23.
OBJECTIVE
The aim of this study was to conduct a systematic review and meta-analysis to investigate the impact of premorbid beta-blockers on mortality in patients with sepsis.
DATA SOURCES
We searched EMBASE, the Cochrane Central Register of Controlled Trials, and MEDLINE for eligible studies. The protocol was registered at the PROSPERO (CRD42021256813).
STUDY SELECTION
Two authors independently evaluated the following inclusion criteria: (1) randomized controlled trials, cohort studies, cross-sectional studies; (2) patients with sepsis aged ≥18 years, and (3) premorbid beta-blocker use.
DATA EXTRACTION
Two authors extracted the patients' characteristics and outcomes independently. All analyses were performed using the random-effects models. The primary outcome was short-term mortality, defined as mortality within 30 days, in-hospital or intensive care unit mortality.
DATA SYNTHESIS
Ten studies (n = 24 748 patients) were included. The pooled odds ratio (OR) of short-term mortality associated with the premorbid use of beta-blockers was 0.85 (95% confidence interval [CI], 0.69-1.04; = .12; = 50%). Five studies reported an adjusted OR of short-term mortality. The pooled adjusted OR of short-term mortality associated with the premorbid use of beta-blockers was 0.73 (95% CI, 0.65-0.83; < .001; = 0%).
CONCLUSION
Premorbid beta-blockers were associated with a lower short-term mortality in patients with sepsis.
目的
本研究旨在进行一项系统评价和荟萃分析，以调查病前使用β受体阻滞剂对脓毒症患者死亡率的影响。
数据来源
我们检索了EMBASE、Cochrane对照试验中央注册库和MEDLINE以查找符合条件的研究。该方案已在国际前瞻性系统评价注册库（PROSPERO，注册号：CRD42021256813）登记。
研究选择
两位作者独立评估以下纳入标准：（1）随机对照试验、队列研究、横断面研究；（2）年龄≥18岁的脓毒症患者；（3）病前使用β受体阻滞剂。
数据提取
两位作者独立提取患者特征和结局。所有分析均采用随机效应模型。主要结局为短期死亡率，定义为30天内死亡、住院期间或重症监护病房死亡率。
数据综合
纳入10项研究（n = 24748例患者）。病前使用β受体阻滞剂相关的短期死亡率合并比值比（OR）为0.85（95%置信区间[CI]，0.69 - 1.04；I² = 0.12；Heterogeneity = 50%）。5项研究报告了调整后的短期死亡率OR。病前使用β受体阻滞剂相关的短期死亡率合并调整后OR为0.73（95%CI，0.65 - 0.83；P < 0.001；I² = 0%）。
结论
病前使用β受体阻滞剂与脓毒症患者较低的短期死亡率相关。
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