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Aetiology
Cohort study
Perioperative β-blockade improves outcomes in higher risk patients following non-cardiac surgery
  1. Prashant Vaishnava,
  2. Kim A Eagle
  1. The University of Michigan Health System, Ann Arbor, Michigan, USA
  1. Correspondence to: Dr Kim A Eagle, The University of Michigan Health System, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA; keagle{at}med.umich.edu

https://doi.org/10.1136/eb-2013-101408

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    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.OpenUrlCrossRefPubMedWeb of Science

    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 …

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    Footnotes

    • Competing interests None.