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A nationwide observ...
A nationwide observational cohort study of the relationship between beta-blockade and survival after hip fracture surgery
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- Ahl, Rebecka, 1987- (author)
- Karolinska Institutet,Örebro universitet,Institutionen för medicinska vetenskaper,Division of Trauma and Emergency Surgery, Department of Surgery, Karolinska University Hospital, Stockholm, Sweden; Division of Surgery, Department of Clinical Science Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
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- Mohammad Ismail, Ahmad, 1993- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Department of Orthopedic Surgery, Örebro University Hospital, Örebro, Sweden
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- Borg, Tomas, 1963- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Orthopedic Surgery, Örebro University Hospital, Örebro, Sweden
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- Sjölin, Gabriel, 1979- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Division of Trauma and Emergency Surgery, Department of Surgery, Örebro University Hospital, Örebro, Sweden
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- Forssten, Maximilian Peter, 1996- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Department of Orthopedic Surgery, Örebro University Hospital, Örebro, Sweden
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- Cao, Yang, Associate Professor, 1972- (author)
- Karolinska Institutet,Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Clinical Epidemiology and Biostatistics
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- Wretenberg, Per, 1963- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Department of Orthopedic Surgery, Örebro University Hospital, Örebro, Sweden
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- Mohseni, Shahin, 1978- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Division of Trauma and Emergency Surgery, Department of Surgery, Örebro University Hospital, Örebro, Sweden
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(creator_code:org_t)
- 2021-01-28
- 2022
- English.
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In: European Journal of Trauma and Emergency Surgery. - : Urban und Vogel Medien und Medizin Verlagsgesellsc. - 1863-9933 .- 1863-9941. ; 48:2, s. 743-751
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https://doi.org/10.1...
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https://link.springe...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
Subject headings
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- PURPOSE: Despite advances in the care of hip fractures, this area of surgery is associated with high postoperative mortality. Downregulating circulating catecholamines, released as a response to traumatic injury and surgical trauma, is believed to reduce the risk of death in noncardiac surgical patients. This effect has not been studied in hip fractures. This study aims to assess whether survival benefits are gained by reducing the effects of the hyper-adrenergic state with beta-blocker therapy in patients undergoing emergency hip fracture surgery.METHODS: This is a retrospective nationwide observational cohort study. All adults [Formula: see text] 18 years were identified from the prospectively collected national quality register for hip fractures in Sweden during a 10-year period. Pathological fractures were excluded. The cohort was subdivided into beta-blocker users and non-users. Poisson regression with robust standard errors and adjustments for confounders was used to evaluate 30-day mortality.RESULTS: 134,915 patients were included of whom 38.9% had ongoing beta-blocker therapy at the time of surgery. Beta-blocker users were significantly older and less fit for surgery. Crude 30-day all-cause mortality was significantly increased in non-users (10.0% versus 3.7%, p < 0.001). Beta-blocker therapy resulted in a 72% relative risk reduction in 30-day all-cause mortality (incidence rate ratio 0.28, 95% CI 0.26-0.29, p < 0.001) and was independently associated with a reduction in deaths of cardiovascular, respiratory, and cerebrovascular origin and deaths due to sepsis or multiorgan failure.CONCLUSIONS: Beta-blockers are associated with significant survival benefits when undergoing emergency hip fracture surgery. Outlined results strongly encourage an interventional design to validate the observed relationship.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Ortopedi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Orthopaedics (hsv//eng)
Keyword
- Beta-blockers
- Hip fractures
- Mortality
Publication and Content Type
- ref (subject category)
- art (subject category)
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Ahl, Rebecka, 19 ...
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Mohammad Ismail, ...
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Borg, Tomas, 196 ...
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Sjölin, Gabriel, ...
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Forssten, Maximi ...
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Cao, Yang, Assoc ...
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Wretenberg, Per, ...
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Mohseni, Shahin, ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Orthopaedics
- Articles in the publication
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European Journal ...
- By the university
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Örebro University
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Karolinska Institutet