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Search: onr:"swepub:oai:DiVA.org:oru-74248" > β-Blockade in Recta...

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  • Ahl, Rebecka,1987-Örebro universitet,Institutionen för medicinska vetenskaper,Department of Surgery, Karolinska University Hospital, Stockholm, Sweden (author)

β-Blockade in Rectal Cancer Surgery : A Simple Measure of Improving Outcomes

  • Article/chapterEnglish2020

Publisher, publication year, extent ...

  • Lippincott Williams & Wilkins,2020
  • printrdacarrier

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  • LIBRIS-ID:oai:DiVA.org:oru-74248
  • https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-74248URI
  • https://doi.org/10.1097/SLA.0000000000002970DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:143413344URI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • OBJECTIVE: To ascertain whether regular β-blocker exposure can improve short- and long-term outcomes after rectal cancer surgery.BACKGROUND: Surgery for rectal cancer is associated with substantial morbidity and mortality. There is increasing evidence to suggest that there is a survival benefit in patients exposed to β-blockers undergoing non-cardiac surgery. Studies investigating the effects on outcomes in patients subjected to surgery for rectal cancer are lacking.METHODS: All adult patients undergoing elective abdominal resection for rectal cancer over a 10-year period were recruited from the prospectively collected Swedish Colorectal Cancer Registry. Patients were subdivided according to preoperative β-blocker exposure status. Outcomes of interest were 30-day complications, 30-day cause-specific mortality, and 1-year all-cause mortality. The association between β-blocker use and outcomes were analyzed using Poisson regression model with robust standard errors for 30-day complications and cause-specific mortality. One-year survival was assessed using Cox proportional hazards regression model.RESULTS: A total of 11,966 patients were included in the current study, of whom 3513 (29.36%) were exposed to regular preoperative β-blockers. A significant decrease in 30-day mortality was detected (incidence rate ratio = 0.06, 95% confidence interval: 0.03-0.13, P < 0.001). Deaths of cardiovascular nature, respiratory origin, sepsis, and multiorgan failure were significantly lower in β-blocker users, as were the incidences in postoperative infection and anastomotic failure. The β-blocker positive group had significantly better survival up to 1 year postoperatively with a risk reduction of 57% (hazard ratio = 0.43, 95% confidence interval: 0.37-0.52, P < 0.001).CONCLUSIONS: Preoperative β-blocker use is strongly associated with improved survival and morbidity after abdominal resection for rectal cancer.

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  • Matthiessen, PeterSchool of Medical Sciences, Örebro University, Örebro, Sweden; Department of Surgery, Örebro University Hospital, Örebro, Sweden (author)
  • Fang, XinInstitute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden (author)
  • Cao, Yang,Associate Professor,1972-Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Clinical Epidemiology and Biostatistics(Swepub:oru)yco (author)
  • Sjölin, Gabriel,1979-Örebro universitet,Institutionen för medicinska vetenskaper,Department of Surgery, Örebro University Hospital, Örebro, Sweden(Swepub:oru)glsn (author)
  • Lindgren, RickardDepartment of Surgery, Örebro University Hospital, Örebro, Sweden (author)
  • Ljungqvist, Olle,1954-Karolinska Institutet,Örebro universitet,Institutionen för medicinska vetenskaper,Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden(Swepub:oru)olt (author)
  • Mohseni, Shahin,1978-Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Surgery(Swepub:oru)snmi (author)
  • Örebro universitetInstitutionen för medicinska vetenskaper (creator_code:org_t)

Related titles

  • In:Annals of Surgery: Lippincott Williams & Wilkins271:1, s. 140-1460003-49321528-1140

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