Effects of beta-blockers use on mortality of patients with acute respiratory distress syndrome: a retrospective cohort study

被引:0
作者
Dong, Yukang [1 ,2 ]
Sun, Run [2 ]
Fu, Jiangquan [3 ]
Huang, Rui [3 ]
Yao, Huan [4 ,5 ]
Wang, Jingni [1 ]
Wang, Ying [1 ]
Shen, Feng [1 ]
机构
[1] Guizhou Med Univ, Affiliated Hosp, Dept Intens Care Unit, Guiyang, Peoples R China
[2] Guizhou Prov Peoples Hosp, Dept Emergency, Guiyang, Peoples R China
[3] Guizhou Med Univ, Affiliated Hosp, Dept Emergency, Intens Care Unit, Guiyang, Peoples R China
[4] Cent South Univ, Xiangya Sch Nursing, Changsha, Hunan, Peoples R China
[5] Guizhou Prov Peoples Hosp, Nursing Dept, Guiyang, Guizhou, Peoples R China
关键词
beta-blockers; acute respiratory distress syndrome; retrospective cohort study; mortality; MIMIC IV databases; SYSTEMIC INFLAMMATION; SEPTIC SHOCK; BLOCKADE; ESMOLOL; EPIDEMIOLOGY; PROPRANOLOL; SURVIVAL; OUTCOMES; INJURY; SEPSIS;
D O I
10.3389/fphys.2024.1332571
中图分类号
Q4 [生理学];
学科分类号
071003 ;
摘要
Introduction: Acute respiratory distress syndrome (ARDS) remains a challenging disease with limited prevention and treatment options. The usage of beta-blockers may have potential benefits in different critical illnesses. This study aimed to investigate the correlation between beta-blocker therapy and mortality in patients with ARDS. Materials and methods: This retrospective cohort study utilized data from the Medical Information Mart for Intensive Care (MIMIC) IV database and focused on patients diagnosed with ARDS. The primary outcome of the study was 30-day mortality. To account for confounding factors, a multivariable analysis was performed. Propensity score matching (PSM) was carried out on a 1:1 ratio. Robust assessments were conducted using inverse probability weighting (IPTW), standardized mortality ratio weighting (SMRW), pairwise algorithms (PA), and overlap weights (OW). Results: A total of 1,104 patients with ARDS were included in the study. Univariate and multivariate Cox regression analyses found that the 30-day mortality for 489 patients (23.7%) who received beta-blockers was significantly lower than the mortality rate of 615 patients (35.9%) who did not receive beta-blockers. After adjusting for potential confounders through PSM and propensity score, as well as utilizing IPTW, SMRW, PA, and OW, the results remained robust, with the hazard ratios (HR) ranging from 0.42 to 0.58 and all p-values < 0.001. Evaluation of the E-values indicated the robustness of the results even in the presence of unmeasured confounding. Conclusion: The findings suggest a potential association between beta-blocker usage and reduced mortality in critically ill patients with ARDS. However, further validation of this observation is needed through randomized controlled trials.
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