Cochrane · systematic review · CD013438
Perioperative beta‐blockers for preventing surgery‐related mortality and morbidity in adults undergoing non‐cardiac surgery
Blessberger, H, Lewis, SR, Pritchard, MW, et al. · Cochrane Database of Systematic Reviews · 2019 · Cochrane Library
AnaesthesiaAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
7
current version
GRADE rated
7
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 1 · 14.3%Low 5 · 71.4%Moderate 1 · 14.3%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Perioperative beta‐blockers compared to placebo or standard care for preventing surgery‐related mortality and morbidity in adults undergoing non‐cardiac surgery
Population: adults undergoing non‐cardiac surgery under general anaesthesia (to include: low‐risk, medium‐risk, and high‐risk surgeries)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Early all‐cause mortality (within 30 days) Perioperative beta‐blockers vs placebo or standard care | RR 1.17 [0.89, 1.54] | 16 studies · 11446 participants | Low Downgraded: risk of bias, inconsistency |
Acute myocardial infarction (within 30 days) Perioperative beta‐blockers vs placebo or standard care | RR 0.72 [0.6, 0.87] | 12 studies · 10520 participants | Low Downgraded: risk of bias, inconsistency |
Cerebrovascular events (within 30 days) Perioperative beta‐blockers vs placebo or standard care | RR 1.65 [0.97, 2.81] | 6 studies · 9460 participants | Low Downgraded: risk of bias, inconsistency |
Ventricular arrhythmias (within 30 days) Perioperative beta‐blockers vs placebo or standard care | RR 0.72 [0.35, 1.47] | 5 studies · 476 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Atrial fibrillation or atrial flutter, or both (within 30 days) Perioperative beta‐blockers vs placebo or standard care | RR 0.41 [0.21, 0.79] | 9 studies · 9080 participants | Low Downgraded: risk of bias, inconsistency |
Bradycardia (within 30 days; as defined by study authors, minimum heart rate < 60 beats per minute or requiring medication) Perioperative beta‐blockers vs placebo or standard care | RR 2.49 [1.74, 3.56] | 49 studies · 12239 participants | Low Downgraded: risk of bias, inconsistency |
Hypotension (within 30 days; as defined by study authors, minimum systolic blood pressure < 90 mmHg or requiring medication) Perioperative beta‐blockers vs placebo or standard care | RR 1.4 [1.29, 1.51] | 49 studies · 12304 participants | Moderate Downgraded: risk of bias |