Effect of beta‐blocker therapy on early mortality after emergency colonic cancer surgery.
Published: 27th September 2018
Authors: R. Ahl, P. Matthiessen, X. Fang, Y. Cao, G. Sjolin, R. Lindgren et al.
Emergency colorectal cancer surgery is associated with significant mortality. Induced adrenergic hyperactivity is thought to be an important contributor. Downregulating the effects of circulating catecholamines may reduce the risk of adverse outcomes. This study assessed whether regular preoperative beta‐blockade reduced mortality after emergency colonic cancer surgery.
This cohort study used the prospectively collected Swedish Colorectal Cancer Registry to recruit all adult patients requiring emergency colonic cancer surgery between 2011 and 2016. Patients were subdivided into those receiving regular beta‐blocker therapy before surgery and those who were not (control). Demographics and clinical outcomes were compared. Risk factors for 30‐day mortality were evaluated using Poisson regression analysis.
A total of 3187 patients were included, of whom 685 (21·5 per cent) used regular beta‐blocker therapy before surgery. The overall 30‐day mortality rate was significantly reduced in the beta‐blocker group compared with controls: 3·1 (95 per cent c.i. 1·9 to 4·7) versus 8·6 (7·6 to 9·8) per cent respectively (P < 0·001). Beta‐blocker therapy was the only modifiable protective factor identified in multivariable analysis of 30‐day all‐cause mortality (incidence rate ratio 0·31, 95 per cent c.i. 0·20 to 0·47; P < 0·001) and was associated with a significant reduction in death of cardiovascular, respiratory, sepsis and multiple organ failure origin.
Preoperative beta‐blocker therapy may be associated with a reduction in 30‐day mortality following emergency colonic cancer surgery.Full text
You may also be interested in
Authors: C. T. Aquina, A. Z. Becerra, Z. Xu, C. F. Justiniano, K. Noyes, J. R. T. Monson et al.
Notes: Non‐operative management better
Cost‐effectiveness of liver transplantation in patients with colorectal metastases confined to the liver.
Authors: G. M. W. Bjørnelv, S. Dueland, P.‐D. Line, P. Joranger, Å. A. Fretland, B. Edwin et al.
Notes: Not for every country
Systematic review of treatment intensification using novel agents for chemoradiotherapy in rectal cancer. BJS 2018; 105: 1553-1572.
Authors: R. Clifford, N. Govindarajah, J. L. Parsons, S. Gollins, N. P. West, D. Vimalachandran et al.
Notes: Promising agents coming
Authors: H. Elfeki, H. M. Larsen, K. J. Emmertsen, P. Christensen, M. Youssef, W. Khafagy et al.
Notes: Sigmoid resection associated with bowel dysfunction
Authors: J. Segelman, C. Buchli, A. Svanström Röjvall, P. Matthiessen, S. Arver, M. Bottai et al.
Notes: Ovarian androgens reduced
Randomized clinical trial
Randomized clinical trial of short or long interval between neoadjuvant chemoradiotherapy and surgery for rectal cancer. BJS 2018; 105: 1417-1425.
Authors: E. Akgun, C. Caliskan, O. Bozbiyik, T. Yoldas, M. Sezak, S. Ozkok et al.
Notes: Worth waiting
Authors: M. Baré, L. Mora, N. Torà, M. J. Gil, I. Barrio, P. Collera et al.
Notes: Defines risk
Preoperative oral care and effect on postoperative complications after major cancer surgery. BJS 2018; 105: 1688-1696.
Authors: M. Ishimaru, H. Matsui, S. Ono, Y. Hagiwara, K. Morita, H. Yasunaga et al.
Notes: Preoperative dental care reduces postoperative pneumonia
Prognostic implications of MRI‐detected lateral nodal disease and extramural vascular invasion in rectal cancer.
Authors: D. P. Schaap, A. Ogura, J. Nederend, M. Maas, J. S. Cnossen, G. J. Creemers et al.
Notes: Defines recurrence risk
Multicentre international trial of laparoscopic lavage for Hinchey III acute diverticulitis (LLO Study).
Authors: G. A. Binda, M. A. Bonino, G. Siri, S. Di Saverio, G. Rossi, R. Nascimbeni et al.
Notes: Successful in the majority
Effectiveness of a multidisciplinary patient care bundle for reducing surgical‐site infections. BJS 2018; 105: 1680-1687.
Authors: M. R. Weiser, M. Gonen, S. Usiak, T. Pottinger, P. Samedy, D. Patel et al.
Notes: Protocol‐driven programme works