Article Figures & Data
Tables
- Table 1
Patient demographics and clinical characteristics in β-blocker unexposed (BB−) and β-blocker exposed (BB+) patients undergoing surgery for hip fracture
BB− BB+ P value n=1543 n=900 Age in years, mean (SD) 81.1 (10.6) 83.4 (8.3) <0.001 Sex, n (%) 0.34 Female 1049 (68.0) 595 (66.1) Male 494 (32.0) 305 (33.9) Type of β-blocker, n (%) – Atenolol – 209 (23.2) Bisoprolol – 293 (32.6) Metoprolol – 350 (38.9) Other – 48 (5.3) ASA classification, n (%) <0.001 1 160 (10.4) 24 (2.8) 2 709 (45.9) 292 (32.4) 3 591 (38.3) 472 (52.4) 4 75 (4.9) 110 (12.2) Missing 8 (0.5) 2 (0.2) Charlson Comorbidity Index, n (%) <0.001 ≤4 603 (39.1) 180 (20.0) 5–6 584 (37.8) 338 (37.6) ≥7 356 (23.1) 382 (42.4) Fracture type, n (%) 0.13 Non-displaced cervical (Garden 1–2) 213 (13.8) 108 (12.0) Displaced cervical (Garden 3–4) 565 (36.6) 307 (34.1) Basicervical 72 (4.7) 39 (4.3) Pertrochanteric (two fragments) 361 (23.4) 226 (25.1) Pertrochanteric (multiple fragments) 237 (15.4) 142 (15.8) Subtrochanteric 95 (6.2) 78 (8.7) Type of surgery, n (%) 0.22 One screw or pin 2 (0.1) 2 (0.2) Two screws or pins 322 (20.9) 162 (18.0) Three screws or pins 2 (0.1) 1 (0.1) Screws or pins with side plate 546 (35.4) 336 (37.3) Intramedullary rod 239 (15.5) 162 (18.0) Hemiarthroplasty 309 (20.0) 182 (20.2) Total hip replacement 123 (8.0) 55 (6.1) ASA, American Society of Anesthesiologists; SD, Standard deviation.
- Table 2
Preoperative comorbidities in β-blocker unexposed (BB−) and β-blocker exposed (BB+) patients undergoing surgery for hip fracture
BB− BB+ P value n=1543 n=900 Myocardial infarction, n (%) 131 (8.5) 249 (27.7) <0.001 Heart failure, n (%) 131 (8.5) 295 (32.8) <0.001 Peripheral vascular disease, n (%) 76 (4.9) 104 (11.6) <0.001 Cerebrovascular event, n (%) 311 (20.2) 284 (31.6) <0.001 Dementia, n (%) 405 (26.2) 169 (18.8) <0.001 Chronic obstructive pulmonary disease, n (%) 135 (8.7) 88 (9.8) 0.39 Connective tissue disease, n (%) 30 (1.9) 10 (1.1) 0.11 Peptic ulcer disease, n (%) 144 (9.3) 105 (11.7) 0.06 Liver disease, n (%) 22 (1.4) 9 (1.0) 0.36 Diabetes mellitus, n (%) <0.001 Uncomplicated 93 (6.0) 68 (7.6) End-organ damage 84 (5.4) 127 (14.1) Hemiplegia, n (%) 38 (2.5) 31 (3.4) 0.15 Chronic kidney disease, n (%) 62 (4.0) 115 (12.8) <0.001 Cancer, n (%) 0.33 Local tumor 297 (19.2) 189 (21.0) Metastatic 41 (2.7) 30 (3.3) Leukemia, n (%) 9 (0.6) 8 (0.9) 0.38 Lymphoma, n (%) 7 (0.5) 6 (0.7) 0.48 - Table 3
Outcomes in β-blocker unexposed (BB−) and β-blocker exposed (BB+) patients undergoing surgery for hip fracture
BB− BB+ P value n=1543 n=900 Hospital length of stay (days) <0.001 Mean (SD) 8.5 (5.8) 9.8 (6.5) Median (IQR) 7 (5, 11) 9 (5, 12) 30-day mortality, n (%) 119 (7.7) 82 (9.1) 0.22 90-day mortality, n (%) 209 (13.5) 145 (16.1) 0.08 Adjusted IRR* 30-day mortality, IRR (95% CI) Ref 0.79 (0.60 to 1.03) 0.07 90-day mortality, IRR (95% CI) Ref 0.82 (0.68 to 0.98) 0.03 *Poisson regression model with robust standard errors, multiple imputation was used for missing values. Model adjusted for age, sex, Charlson Comorbidity Index, American Society of Anesthesiologists (ASA) classification, fracture type and type of surgery. Multiple imputation method for missing ASA values.
CI, Confidence interval; IQR, Interquartile range; IRR, incidence rate ratio; SD, Standard deviation.
- Table 4
Incidence rate ratio (IRR) for 90-day mortality after surgery for hip fracture
Variable IRR (95% CI) P value β-blocker therapy No Ref Yes 0.82 (0.68 to 0.98) 0.03 Age 1.05 (1.04 to 1.07) <0.001 Sex Female Ref Male 1.49 (1.23 to 1.80) <0.001 Charlson Comorbidity Index ≤4 Ref 5–6 2.03 (1.41 to 2.94) <0.001 ≥7 2.87 (1.97 to 4.17) <0.001 ASA classification 1 Ref 2 1.87 (0.79 to 4.46) 0.15 3 2.92 (1.23 to 6.92) 0.01 4 5.24 (2.16 to 12.73) <0.001 Fracture type Non-displaced cervical (Garden 1–2) Ref Displaced cervical (Garden 3–4) 1.07 (0.73 to 1.57) 0.72 Basicervical 1.45 (0.80 to 2.63) 0.22 Pertrochanteric (two fragments) 1.68 (0.98 to 2.86) 0.05 Pertrochanteric (multiple fragments) 1.37 (0.79 to 2.38) 0.26 Subtrochanteric 1.13 (0.58 to 2.21) 0.72 Type of surgery Screws or pins Ref Screws or pins with side plate 0.87 (0.54 to 1.40) 0.56 Intramedullary rod 0.84 (0.50 to 1.43) 0.52 Hemiarthroplasty 0.95 (0.66 to 1.35) 0.75 Total hip replacement 0.52 (0.23 to 1.20) 0.12 Poisson regression model with robust standard errors, multiple imputation was used for missing values. Model adjusted for age, sex, Charlson Comorbidity Index, ASA classification, fracture type and type of surgery. Multiple imputation method for missing ASA values.
ASA, American Society of Anesthesiologists; CI, Confidence interval.
