Perioperative {beta}-blockade improves outcomes in higher risk patients following non-cardiac surgery

Commentary on: London MJ, Hur K, Schwartz GG, et al.. Association of perioperative β-blockade with mortality and cardiovascular morbidity following major noncardiac surgery. JAMA 2013;309:1704–13. Context There has been recent controversy in the perioperative community amid allegations of scientific misconduct and there remains uncertainty about the effectiveness and safety of perioperative β-blockade in patients undergoing non-cardiac surgery.1 Current American Heart Association/American College of Cardiology Foundation (AHA/ACCF) Guidelines on perioperative evaluation and care for non-cardiac surgery limit a class I practice recommendation to the continuation of pre-existing β-blockade.2 Methods The authors conducted a retrospective cohort analysis of a population-based sample of 136 745 patients who were 1:1 matched on propensity scores treated at 104 veterans affairs (VA) medical centres (96.3% men in full cohort). Perioperative risk, process and outcome data from patients undergoing non-cardiac surgical procedures were obtained from the VA Surgical Quality...
Source: Evidence-Based Medicine - Category: Internal Medicine Authors: Tags: EBM Aetiology, Epidemiologic studies, Drugs: cardiovascular system, Stroke, Hypertension, Interventional cardiology, Ischaemic heart disease, Ethics Source Type: research