Effect of oral β-blocker on short and long-term mortality in patients with acute respiratory failure: results from the BASEL-II-ICU study
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Effect of oral β-blocker on short and long-term mortality in patients with acute respiratory failure: results from the BASEL-II-ICU study. / Noveanu, Markus; Breidthardt, Tobias; Reichlin, Tobias; Gayat, Etienne; Potocki, Mihael; Pargger, Hans; Heise, Antje; Meissner, Julia; Twerenbold, Raphael; Muravitskaya, Natalia; Mebazaa, Alexandre; Mueller, Christian.
In: CRIT CARE, Vol. 14, No. 6, 2010, p. R198.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Effect of oral β-blocker on short and long-term mortality in patients with acute respiratory failure: results from the BASEL-II-ICU study
AU - Noveanu, Markus
AU - Breidthardt, Tobias
AU - Reichlin, Tobias
AU - Gayat, Etienne
AU - Potocki, Mihael
AU - Pargger, Hans
AU - Heise, Antje
AU - Meissner, Julia
AU - Twerenbold, Raphael
AU - Muravitskaya, Natalia
AU - Mebazaa, Alexandre
AU - Mueller, Christian
PY - 2010
Y1 - 2010
N2 - INTRODUCTION: Acute respiratory failure (ARF) is responsible for about one-third of intensive care unit (ICU) admissions and is associated with adverse outcomes. Predictors of short- and long-term outcomes in unselected ICU-patients with ARF are ill-defined. The purpose of this analysis was to determine predictors of in-hospital and one-year mortality and assess the effects of oral beta-blockers in unselected ICU patients with ARF included in the BASEL-II-ICU study.METHODS: The BASEL II-ICU study was a prospective, multicenter, randomized, single-blinded, controlled trial of 314 (mean age 70 (62 to 79) years) ICU patients with ARF evaluating impact of a B-type natriuretic peptide- (BNP) guided management strategy on short-term outcomes.RESULTS: In-hospital mortality was 16% (51 patients) and one-year mortality 41% (128 patients). Multivariate analysis assessed that oral beta-blockers at admission were associated with a lower risk of both in-hospital (HR 0.33 (0.14 to 0.74) P = 0.007) and one-year mortality (HR 0.29 (0.16 to 0.51) P = 0.0003). Kaplan-Meier analysis confirmed the lower mortality in ARF patients when admitted with oral beta-blocker and further shows that the beneficial effect of oral beta-blockers at admission holds true in the two subgroups of patients with ARF related to cardiac or non-cardiac causes. Kaplan-Meier analysis also shows that administration of oral beta-blockers before hospital discharge gives striking additional beneficial effects on one-year mortality.CONCLUSIONS: Established beta-blocker therapy appears to be associated with a reduced mortality in ICU patients with acute respiratory failure. Cessation of established therapy appears to be hazardous. Initiation of therapy prior to discharge appears to confer benefit. This finding was seen regardless of the cardiac or non-cardiac etiology of respiratory failure.TRIAL REGISTRATION: clinicalTrials.gov Identifier: NCT00130559.
AB - INTRODUCTION: Acute respiratory failure (ARF) is responsible for about one-third of intensive care unit (ICU) admissions and is associated with adverse outcomes. Predictors of short- and long-term outcomes in unselected ICU-patients with ARF are ill-defined. The purpose of this analysis was to determine predictors of in-hospital and one-year mortality and assess the effects of oral beta-blockers in unselected ICU patients with ARF included in the BASEL-II-ICU study.METHODS: The BASEL II-ICU study was a prospective, multicenter, randomized, single-blinded, controlled trial of 314 (mean age 70 (62 to 79) years) ICU patients with ARF evaluating impact of a B-type natriuretic peptide- (BNP) guided management strategy on short-term outcomes.RESULTS: In-hospital mortality was 16% (51 patients) and one-year mortality 41% (128 patients). Multivariate analysis assessed that oral beta-blockers at admission were associated with a lower risk of both in-hospital (HR 0.33 (0.14 to 0.74) P = 0.007) and one-year mortality (HR 0.29 (0.16 to 0.51) P = 0.0003). Kaplan-Meier analysis confirmed the lower mortality in ARF patients when admitted with oral beta-blocker and further shows that the beneficial effect of oral beta-blockers at admission holds true in the two subgroups of patients with ARF related to cardiac or non-cardiac causes. Kaplan-Meier analysis also shows that administration of oral beta-blockers before hospital discharge gives striking additional beneficial effects on one-year mortality.CONCLUSIONS: Established beta-blocker therapy appears to be associated with a reduced mortality in ICU patients with acute respiratory failure. Cessation of established therapy appears to be hazardous. Initiation of therapy prior to discharge appears to confer benefit. This finding was seen regardless of the cardiac or non-cardiac etiology of respiratory failure.TRIAL REGISTRATION: clinicalTrials.gov Identifier: NCT00130559.
KW - Acute Disease
KW - Administration, Oral
KW - Adrenergic beta-Antagonists/administration & dosage
KW - Aged
KW - Female
KW - Follow-Up Studies
KW - Hospital Mortality/trends
KW - Humans
KW - Intensive Care Units/trends
KW - Male
KW - Middle Aged
KW - Prospective Studies
KW - Respiratory Insufficiency/drug therapy
KW - Single-Blind Method
KW - Survival Rate/trends
KW - Switzerland/epidemiology
KW - Time Factors
KW - Treatment Outcome
U2 - 10.1186/cc9317
DO - 10.1186/cc9317
M3 - SCORING: Journal article
C2 - 21047406
VL - 14
SP - R198
JO - CRIT CARE
JF - CRIT CARE
SN - 1364-8535
IS - 6
ER -