ArticleArchives of surgery (Chicago, Ill. : 1960)2012
β-blocker continuation after noncardiac surgery: a report from the surgical care and outcomes assessment program.
Article in Archives of surgery (Chicago, Ill. : 1960), 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient--2013 update: cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery.Obesity (Silver Spring, Md.) · 2013Guideline
- Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient--2013 update: cosponsored by American Association of Clinical Endocrinologists, the Obesity Society, and American Society for Metabolic & Bariatric Surgery.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical EndocrinologistsGuideline
- Heart Failure in Kidney Transplant Recipients: Narrative Review of Risk Factors, Therapy, and Current Gaps in Management.Cardiology and therapy · 2026Review
- Perioperative Cardiac Complications and Evidence-Based Strategies for Their Management.Cureus · 2025Review
- Revisiting perioperative beta blockade: for what it's worth.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2025Article
- Cardiovascular Events and Preoperative Beta-Blocker Use in Non-Cardiac Surgery: A Prospective Holter-Based Analysis.Medicina (Kaunas, Lithuania) · 2025Observational
- Perioperative Risk: Short Review of Current Approach in Non Cardiac Surgery.Journal of cardiovascular development and disease · 2025Review
- 2023 Guideline for the management of hypertension in the elderly population in China.Journal of geriatric cardiology : JGC · 2024Article
- Association of Discontinuing Preinjury Beta-Adrenergic Blockade Medications With Mortality in Severe Blunt Traumatic Brian Injury.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2023Article
- Pharmacological differences between beta-blockers and postoperative mortality following colon cancer surgery.Scientific reports · 2022Article
- Management of renin-angiotensin-aldosterone inhibitors and other antihypertensives and their clinical effects on pre-anesthesia blood pressure.Anesthesia and pain medicine · 2022Article
- Pre-operative beta-blocker therapy does not affect short-term mortality after esophageal resection for cancer.BMC surgery · 2020Article
- Effects of beta-blocker therapy on mortality after elective colon cancer surgery: a Swedish nationwide cohort study.BMJ open · 2020Article
- Contemporary personalized β-blocker management in the perioperative setting.Journal of anesthesia · 2020Review
- Limited Effect of Beta-blockade on Postoperative Outcome After Laparoscopic Gastric Bypass Surgery.Obesity surgery · 2020Article
- The Relationship Between Severe Complications, Beta-Blocker Therapy and Long-Term Survival Following Emergency Surgery for Colon Cancer.World journal of surgery · 2019Article
- 2019 Chinese guideline for the management of hypertension in the elderly.Journal of geriatric cardiology : JGC · 2019Article
- Evaluating disparities in inpatient surgical cancer care among American Indian/Alaska Native patients.American journal of surgery · 2016Article
- What are the factors influencing outcome among patients admitted to a hospital with a proximal humeral fracture?Clinical orthopaedics and related research · 2013Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundDespite limited evidence of effect, β-blocker continuation has become a national quality improvement metric.
objectiveTo determine the effect of β-blocker continuation on outcomes in patients undergoing elective noncardiac surgery. DESIGN, SETTING, AND PATIENTS: The Surgical Care and Outcomes Assessment Program is a Washington quality improvement benchmarking initiative based on clinical data from more than 55 hospitals. Linking Surgical Care and Outcomes Assessment Program data to Washington's hospital admission and vital status registries, we studied patients undergoing elective colorectal and bariatric surgical procedures at 38 hospitals between January 1, 2008, and December 31, 2009.
main outcome measuresMortality, cardiac events, and the combined adverse event of cardiac events and/or mortality.
resultsOf 8431 patients, 23.5% were taking β-blockers prior to surgery (mean [SD] age, 61.9 [13.7] years; 63.0% were women). Treatment with β-blockers was continued on the day of surgery and during the postoperative period in 66.0% of patients. Continuation of β-blockers both on the day of surgery and postoperatively improved from 57.2% in the first quarter of 2008 to 71.3% in the fourth quarter of 2009 (P value <.001). After adjusting for risk characteristics, failure to continue β-blocker treatment was associated with a nearly 2-fold risk of 90-day combined adverse event (odds ratio, 1.97; 95% CI, 1.19-3.26). The odds were even greater among patients with higher cardiac risk (odds ratio, 5.91; 95% CI, 1.40- 25.00). The odds of combined adverse events continued to be elevated 1 year postoperatively (odds ratio, 1.66; 95% CI, 1.08-2.55).
conclusionsβ-Blocker continuation on the day of and after surgery was associated with fewer cardiac events and lower 90-day mortality. A focus on β-blocker continuation is a worthwhile quality improvement target and should improve patient outcomes.
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