Setting: Record linkage of administrative databases of Italian patients hospitalized for sepsis during years 2003–2008 were identified and followed up for all-cause mortality at 28 days.
Interventions: None.
Measurements and Main Results: We identified 9,465 patients aged ≥40 yrs who were hospitalized in critical care units for sepsis. Of these, 1,061 patients were on chronic prescription with β-blockers and 8404 were not previously treated. Despite a higher risk profile, patients previously prescribed with β-blockers had lower mortality at 28 days (188/1061 [17.7%]) than those previously untreated (1857/8404 [22.1%]) (odds ratio 0.78; 95% confidence interval 0.66–0.93; p = .005 for unadjusted analysis, and odds ratio 0.81; 95% confidence interval 0.68–0.97; p = .025 for adjusted analyses). Sensitivity and pair-matched results confirm the primary findings.
Conclusions: As far as we are aware, this pharmacoepidemiologic assessment is the largest to examine the potential association of previous β-blocker prescription and mortality in patients with sepsis. Chronic prescription of β-blockers may confer a survival advantage to patients who subsequently develop sepsis with organ dysfunction and who are admitted to an intensive care unit. Prospective randomized clinical trials should formally test this hypothesis.
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