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Preoperative beta-blocker usage : is it really worthy of being a quality indicator ? BACKGROUND Since 2007 , the use of preoperative β-blockers has been used as a quality standard for patients undergoing coronary artery bypass graft surgery . Recent studies have called into question of the benefit of empiric preoperative β-blocker use . METHODS Data were extracted from our Society of Thoracic Surgeons certified database for patients undergoing isolated coronary artery bypass graft surgery from 2000 to 2008 . We compared the outcomes for patients who received preoperative β-blockers with those of patients who did not . RESULTS The study group had 12,855 patients , of whom 7,967 ( 62.0 % ) were treated preoperatively with β-blockers . Using propensity matching , we selected two matched groups of 4,474 patients with preoperative β-blocker use and 4,474 not using preoperative β-blockers . In the unmatched cohort , only deep sternal infection ( 0.3 % versus 0.5 % without β-blockers ; p=0.032 ) , pneumonia ( 1.9 % versus 2.4 % without β-blockers ; p=0.039 ) , and intraoperative blood usage ( 37.2 % versus 34.1 % without β-blockers ; p < 0.001 ) reached statistically significant difference . In the matched groups , there was no difference between adverse event rates in patients treated with β-blockers and those who were not . The number of patients requiring intraoperative blood product use was significantly higher among β-blocker-treated patients ( p=0.004 ) . Calculating the adjusted odds ratios showed that in the matched groups , the preoperative use of β-blockers was not an independent predictor of mortality . CONCLUSIONS A rational for preoperative β-blockade exists . However , as with any medical intervention , its application should be tailored to specific clinical scenarios . With no differences in mortality or morbidity , our findings do not support preoperative β-blockade as a useful quality indicator for coronary artery bypass graft surgery .
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Intervention_Pharmacological
beta-blocker usage
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Outcome_Physical
deep sternal infection
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Outcome_Physical
pneumonia
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Outcome_Physical
intraoperative blood
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Outcome_Adverse-effects
adverse event
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Outcome_Other
requiring intraoperative blood product
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Participant_Condition
undergoing isolated coronary artery bypass graft surgery
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Participant_Sample-size
12,855