Department of Anesthesiology, Meizhou People's Hospital, Meizhou, Guangdong, China.
BMC Cardiovasc Disord. 2024 Oct 24;24(1):587. doi: 10.1186/s12872-024-04271-6.
Metoprolol is commonly administered to critically ill patients; however, its effect on mortality in patients with sepsis-induced cardiomyopathy (SICM) remains uncertain. This study aimed to investigate the relationship between metoprolol use and mortality in patients with SICM.
Adults with SICM were identified from the MIMIC-IV database. The exposure of interest was metoprolol treatment. The outcomes assessed were 30-day mortality, 1-year mortality, and in-hospital mortality. Kaplan-Meier survival analysis evaluated the effect of metoprolol on these outcomes. Multivariable Cox proportional hazards and logistic regression analyses were performed to determine the correlation between metoprolol treatment and mortality in patients with SICM.
1163 patients with SICM were identified, with 882 receiving metoprolol treatment (MET group) and 281 not receiving metoprolol treatment (NOMET group). Overall, the 30-day, 1-year, and in-hospital mortality rates were 10.2%, 18.2%, and 8.9%, respectively. Significant differences in mortality existed between the groups. Multivariable Cox analysis revealed that patients in the NOMET group had a higher risk of 1-year mortality (adjusted hazard ratio [HR] 2.493; 95% confidence interval [CI] 1.800-3.451; P < 0.001) and 30-day mortality (adjusted HR 4.280; 95%CI 2.760-6.637; P < 0.001). Metoprolol treatment was associated with lower in-hospital mortality (odds ratio [OR] 5.076; 95% CI 2.848-9.047; P < 0.001). Subgroup analysis supported these findings.
Metoprolol treatment is associated with reduced all-cause mortality in patients with SICM. Prospective studies are required to validate these findings.
美托洛尔常用于危重症患者，但在脓毒症性心肌病（SICM）患者中的死亡率影响尚不确定。本研究旨在探讨美托洛尔使用与 SICM 患者死亡率之间的关系。
从 MIMIC-IV 数据库中确定 SICM 成人患者。感兴趣的暴露因素为美托洛尔治疗。评估的结局为 30 天死亡率、1 年死亡率和住院死亡率。Kaplan-Meier 生存分析评估了美托洛尔对这些结局的影响。多变量 Cox 比例风险和逻辑回归分析用于确定 SICM 患者中美托洛尔治疗与死亡率之间的相关性。
确定了 1163 例 SICM 患者，其中 882 例接受美托洛尔治疗（MET 组），281 例未接受美托洛尔治疗（NOMET 组）。总体而言，30 天、1 年和住院死亡率分别为 10.2%、18.2%和 8.9%。两组之间的死亡率存在显著差异。多变量 Cox 分析显示，NOMET 组患者 1 年死亡率（调整后危险比 [HR] 2.493；95%置信区间 [CI] 1.800-3.451；P<0.001）和 30 天死亡率（调整后 HR 4.280；95%CI 2.760-6.637；P<0.001）风险更高。美托洛尔治疗与住院死亡率降低相关（比值比 [OR] 5.076；95%CI 2.848-9.047；P<0.001）。亚组分析支持这些发现。
美托洛尔治疗与 SICM 患者全因死亡率降低相关。需要前瞻性研究来验证这些发现。
