β-Adrenergic blockade in patients with dementia and hip fracture is associated with decreased postoperative mortality

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Ioannidis, Ioannis,1967-Örebro universitet,Institutionen för medicinska vetenskaper,Department of Orthopedic Surgery, Örebro University Hospital, Örebro, Sweden (author)

β-Adrenergic blockade in patients with dementia and hip fracture is associated with decreased postoperative mortality

Article/chapterEnglish2022

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2021-06-15
Springer,2022
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LIBRIS-ID:oai:DiVA.org:oru-92390
https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-92390URI
https://doi.org/10.1007/s00068-021-01723-yDOI

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Language:English
Summary in:English

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Subject category:art swepub-publicationtype

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Funding Agency:Örebro University
PURPOSE: Dementia, present in 20% of hip fracture patients, is associated with an almost threefold increase in postoperative mortality risk. These patients have a substantially higher incidence of cardiovascular, respiratory, and cerebrovascular mortality after hip fracture surgery compared to patients without dementia. This study aimed to investigate the association between beta-blocker therapy and postoperative mortality in patients with dementia undergoing hip fracture surgery.METHODS: This nationwide study included all patients in Sweden with the diagnosis of dementia who underwent emergency surgery for a hip fracture between January 2008 and December 2017. Cases where the hip fracture was pathological or conservatively managed were not included. Poisson regression analysis with robust standard errors was performed while controlling for confounders to determine the relationship between beta-blocker therapy and all-cause, as well as cause-specific, postoperative mortality.RESULTS: A total of 26,549 patients met the study inclusion criteria, of whom 8258 (31%) had ongoing beta-blocker therapy at time of admission. After adjusting for clinically relevant variables, the incidence of postoperative mortality in patients receiving beta-blocker therapy was decreased by 50% at 30 days [adj. IRR (95% CI) 0.50 (0.45-0.54), p < 0.001] and 34% at 90 days [adj. IRR (95% CI) 0.66 (0.62-0.70), p < 0.001]. Cause-specific mortality analysis demonstrated a significant reduction in the incidence of postoperative cardiovascular, respiratory, and cerebrovascular death within 30 and 90 days postoperatively.CONCLUSION: Beta-blocker therapy is associated with decreased postoperative mortality in hip fracture patients with dementia up to 90 days after surgery. This finding warrants further investigation.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kirurgi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Surgery hsv//eng
Beta-blocker
Dementia
Hip fracture
Mortality
β-Adrenergic blockade

Added entries (persons, corporate bodies, meetings, titles ...)

Mohammad Ismail, Ahmad,1993-Örebro universitet,Institutionen för medicinska vetenskaper,Department of Orthopedic Surgery, Örebro University Hospital, Örebro, Sweden(Swepub:oru)aml (author)
Forssten, Maximilian Peter,1996-Örebro universitet,Institutionen för medicinska vetenskaper,Department of Orthopedic Surgery, Örebro University Hospital, Örebro, Sweden(Swepub:oru)mmfn (author)
Cao, Yang,Associate Professor,1972-Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Clinical Epidemiology and Biostatistics(Swepub:oru)yco (author)
Bass, Gary Alan,1979-Örebro universitet,Institutionen för medicinska vetenskaper,Division of Traumatology, Surgical Critical Care and Emergency Surgery, University of Pennsylvania, Philadelphia, USA(Swepub:oru)gbs (author)
Borg, Tomas,1963-Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Orthopedic Surgery, Örebro University Hospital, Örebro, Sweden(Swepub:oru)tbg (author)
Mohseni, Shahin,1978-Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Division of Trauma and Emergency Surgery, Department of Surgery, Örebro University Hospital, Örebro, Sweden(Swepub:oru)snmi (author)
Örebro universitetInstitutionen för medicinska vetenskaper (creator_code:org_t)

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In:European Journal of Trauma and Emergency Surgery: Springer48:2, s. 1463-14691863-99331863-9941

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