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β-Blockade in Noncardiac Surgery—Invited Critique
Todd E. Rasmussen, MD
Arch Surg. 2008;143(10):944.
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The article by Kaafarani et al presents a retrospective report of patients operated on at a single institution in 2000. The objective was to determine the effect of β-blockers on perioperative heart rate and perioperative cardiac morbidity and mortality in all noncardiac surgery. The findings suggest that the β-blocker group experienced higher rates of myocardial infarction (2.94% vs 0.74%) and 30-day mortality (2.52% vs 0.25%) compared with the group not receiving β-blockers. The most supported and compelling finding demonstrates that within the β-blocker group those who died in the perioperative period had significantly higher preoperative heart rates than those without perioperative death.
In reviewing this study, one cannot help but wonder if the category "use of preoperative β-blockers" was not itself simply a marker for perioperative morbidity and mortality. The methods state that during frequency matching the preoperative β-blocker group was "matched" with regard to ACC/AHA . . . [Full Text of this Article]
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β-Blockade in Noncardiac Surgery: Outcome at All Levels of Cardiac Risk
Haytham M. A. Kaafarani, Prasad V. Atluri, John Thornby, and Kamal M. F. Itani
Arch Surg. 2008;143(10):940-944.
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