Table 2 Characteristics of included studies
From: The association between premorbid beta blocker exposure and mortality in sepsis—a systematic review
First author | Year of publication | Type of study | Study period (month/year) | Country | Number of centres | Diagnosis | Setting (ED/ICU) | ICU type (medical/surgical) | Outcome | Premorbid beta blocker exposure | Inclusions | Exclusions | Select cohort | No. of patients with premorbid beta blocker use |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Singer et al. [11] | 2017 | Retrospective matched cohort study | 2009–2011 | USA | Medicare Provider and Analysis Review data | Severe sepsis, septic shock | ICU | Mixed | Primary: mortality | Filled prescription within 30 days of admission, including date of admission. Data obtained from Medicare Part D claims data. | Patients admitted with an urgent/emergent hospital admission code, requiring intensive care upon admission, and carrying a primary diagnosis of sepsis or systemic inflammatory response syndrome (SIRS) by ICD9 diagnosis codes, > 65 years, asthma, heart block, 1 year of continuous Part A and Part B coverage, with Part D enrolment. | In hospital claims without ICU admission, Part C enrolment (coverage through healthcare maintenance organizations), beta blocker prescriptions extending into 30 days prior to admission but not through the admission date. | 6839 | 2838 |
Macchia et al. [10] | 2012 | Retrospective matched cohort study | 2003–2008 | Italy | 22 | Sepsis | ICU | Mixed | Primary: mortality | 3 or more filled prescriptions within 4 months of admission. Data obtained from local health authority drug claims database. | Sepsis with codes 038 [septicemia], 020.0 [septicemic], 790.7 [bacteremia], 117.9 [disseminated fungal infection], 112.5 [disseminated candida infection], and 112.81 [disseminated fungal endocarditis]. Admission direct to ICU or transferred to ICU from other hospital departments within 48 h of admission. | < 40 years old, transfer to ICU from other departments 48 h after admission. | 9465 | 1061 |
Hsieh et al. [27] | 2019 | Retrospective matched observational study | 1999–2013 | Taiwan | National Health Insurance Research Database (NHIRD) of Taiwan data | Sepsis, septic shock | – | – | Primary: mortality | Patients were classified as using certain drugs if they took them for more than 1 week within a 3-month period prior to the index date. | First episode of severe sepsis or septic shock. ICD-9-CM coding was used. | Second episode of sepsis. | 33,213 | 1040 |
Fuchs et al. [26] | 2017 | Secondary analysis of prospective observational single-centre trial | 2010–2013 | Germany | 1 | Sepsis, severe sepsis, septic shock | ICU | Surgical | Primary: mortality; survival analysis Secondary: length of stay | Pre-existing oral beta blocker therapy was defined as a treatment started at least 7 days before sepsis onset. | First episode of severe sepsis or septic shock. | < 18 years old, no infection, no chronic beta blocker therapy, no sepsis or septic shock, second episode of sepsis. | 296 | 296 |
Contenti et al. [21] | 2015 | Retrospective cohort study | 2012–2014 | France | 1 | Severe sepsis, septic shock | ED/ICU | – | Primary: initial blood lactate concentration. Secondary: mortality | ‘Premorbid’ not defined. Data obtained from ED observation data or inpatient records | > 18 years old, severe sepsis, septic shock. | – | 260 | 65 |
Sharma et al. [25] | 2016 | Retrospective study | 2013–2014 | ICU | Not specified | Septic shock | ICU | Medical | Peak lactate, cumulative norepinephrine dose and duration, mortality | ‘Premorbid’ not defined. Data obtained from ICU medical records. | Medical ICU, septic shock, vasopressors required. | – | 123 | 48 |
de Roquetaillade et al. [23] | 2018 | Retrospective study | 2008–2016 | France | Not specified | Septic shock | ICU | – | Heart rate, arterial lactate levels, arterial oxygen content, fluid requirements, norepinephrine requirements, duration of mechanical ventilation, mortality | ‘Premorbid’ not defined. | Adult patients diagnosed with septic shock within 48 h. | – | 938 | 230 |
Alsolamy et al. [22] | 2016 | Retrospective cohort study | 1/1/2003–31/12/2013 | Saudi Arabia | 1 | Severe sepsis, septic shock | ICU | – | Primary: mortality | Active prescription 3 months prior to admission. | > 14 years old, severe sepsis and septic shock, previous prescription of beta blockers active for 3 months prior to hospital admission. | – | 4629 | 623 |
Al-Qadi et al. [24] | 2014 | Retrospective study | 2007–2009 | USA | 1 | Severe sepsis, septic shock | ICU | Medical | Primary: mortality | 3 or more months of beta blocker usage prior to admission. Data obtained from electronic records. | Severe sepsis and septic shock, 3 or more months on beta blocker prior to ICU admission. | Patients with comfort care. | 651 | 375 |