Objective

The cardio-protective benefits of β-blockers (BB) from major non-cardiac and vascular settings in cardiac surgery are plausible. Following last year STS annual meeting presentation on the failure of BB as a quality metric, we set to assess this on our institutional isolated CABG data.

Methods

14,892 patients underwent an isolated CABG operation at our institution between April 2000 and March 2015, 103 (0.7%) of these were excluded due to lack of beta-blocker data. We retrospectively reviewed the remaining 14789 patients for the effect of BB on post-operative morbidity and mortality, using logistic regression to adjust for differences in patient characteristics.

Results

Before risk adjustment, BB were significantly associated with reduction in ITU readmission (p<0.001), reintubation (p<0.001) and deep sternal wound infection (p<0.001). After adjustment, BB were significantly associated with reduction in post-operative ITU readmission (p=0.002), and deep sternal wound infection (p=0.003). The adjusted p-value for a reduction in reintubation was 0.0537 (OR = 0.82). BB were not associated with any in-hospital mortality reduction before and after adjustment.

Conclusion

Preoperative BB use is not associated with risk-adjusted mortality. Thus, these data suggest that the routine use of preoperative BB for CABG operations should not be used as a measure of surgical quality.