Table 3.
Effect of perioperative β blockers within the first 30 days after non-cardiac surgery
| Outcome and trials | β blocker groups | Control groups | Risk reduction | 95% confidence interval | 99% confidence interval | I2 |
|---|---|---|---|---|---|---|
| Total mortality | ||||||
| Wallace31 | 4/99 | 2/101 | 2.04 | 0.38 to 10.89 | 0.23 to 18.43 | |
| Bayliff32 | 2/49 | 1/50 | 2.04 | 0.19 to 21.79 | 0.09 to 45.85 | |
| Poldermans33 | 2/59 | 9/53 | 0.20 | 0.05 to 0.88 | 0.03 to 1.41 | |
| Yang37 | 1/246 | 7/250 | 0.15 | 0.02 to 1.17 | 0.01 to 2.26 | |
| Total | 9/453 | 19/454 | 0.56 | 0.14 to 2.31 | 0.09 to 3.60 | 57% |
| Cardiovascular mortality | ||||||
| Wallace31 | 1/99 | 2/101 | 0.51 | 0.05 to 5.54 | 0.02 to 11.71 | |
| Bayliff32 | 2/49 | 1/50 | 2.04 | 0.19 to 21.79 | 0.09 to 45.85 | |
| Poldermans33 | 2/59 | 9/53 | 0.20 | 0.05 to 0.88 | 0.03 to 1.41 | |
| Yang37 | 0/246 | 1/250 | 0.34 | 0.01 to 8.27 | 0.01 to 22.59 | |
| Total | 5/453 | 13/454 | 0.40 | 0.14 to 1.15 | 0.10 to 1.60 | 0% |
| Non-fatal myocardial infarction | ||||||
| Jakobsen30 | 1/18 | 0/18 | 3.00 | 0.13 to 69.09 | 0.05 to 185.13 | |
| Poldermans33 | 0/59 | 9/53 | 0.05 | 0.00 to 0.79 | 0.00 to 1.93 | |
| Raby34 | 0/15 | 1/11 | 0.25 | 0.01 to 5.62 | 0.00 to 14.93 | |
| Zaugg35 | 0/43 | 3/20 | 0.07 | 0.00 to 1.26 | 0.00 to 3.15 | |
| Urban36 | 1/60 | 3/60 | 0.33 | 0.04 to 3.11 | 0.02 to 6.29 | |
| Yang37 | 19/246 | 21/250 | 0.92 | 0.51 to 1.67 | 0.42 to 2.01 | |
| Total | 21/441 | 37/412 | 0.38 | 0.11 to 1.29 | 0.08 to 1.88 | 45% |
| Non-fatal cardiac arrest | ||||||
| Wallace31 | 2/99 | 3/101 | 0.68 | 0.12 to 3.98 | 0.07 to 6.94 | |
| Bayliff32 | 0/49 | 2/50 | 0.20 | 0.01 to 4.14 | 0.00 to 10.67 | |
| Total | 2/148 | 5/151 | 0.50 | 0.11 to 2.29 | 0.07 to 3.70 | 0% |
| Major perioperative cardiovascular events* | ||||||
| Jakobsen30 | 1/18 | 0/18 | 3.00 | 0.13 to 69.09 | 0.05 to 185.13 | |
| Wallace31 | 3/99 | 5/101 | 0.61 | 0.15 to 2.49 | 0.10 to 3.88 | |
| Bayliff32 | 2/49 | 3/50 | 0.68 | 0.12 to 3.90 | 0.07 to 6.74 | |
| Poldermans33 | 2/59 | 18/53 | 0.10 | 0.02 to 0.41 | 0.02 to 0.64 | |
| Raby34 | 0/15 | 1/11 | 0.25 | 0.01 to 5.62 | 0.00 to 14.93 | |
| Zaugg35 | 0/43 | 3/20 | 0.07 | 0.00 to 1.26 | 0.00 to 3.15 | |
| Urban36 | 1/60 | 3/60 | 0.33 | 0.04 to 3.11 | 0.02 to 6.29 | |
| Yang37 | 19/246 | 22/250 | 0.88 | 0.49 to 1.58 | 0.41 to 1.90 | |
| Total | 28/589 | 55/563 | 0.44 | 0.20 to 0.97 | 0.16 to 1.24 | 42% |
| Non-fatal stroke | ||||||
| Wallace31 | 4/99 | 1/101 | 4.08 | 0.46 to 35.87 | 0.23 to 71.02 | NA |
| Congestive heart failure | ||||||
| Magnusson20 | 0/15 | 1/15 | 0.33 | 0.01 to 7.58 | 0.01 to 20.25 | |
| Jakobsen30 | 1/18 | 0/18 | 3.00 | 0.13 to 69.09 | 0.05 to 185.13 | |
| Wallace31 | 9/99 | 7/101 | 1.31 | 0.51 to 3.38 | 0.38 to 4.56 | |
| Bayliff32 | 8/49 | 4/50 | 2.04 | 0.66 to 6.34 | 0.46 to 9.05 | |
| Yang37 | 5/246 | 3/250 | 1.69 | 0.41 to 7.01 | 0.26 to 10.96 | |
| Total | 23/427 | 15/434 | 1.54 | 0.83 to 2.87 | 0.68 to 3.48 | 0% |
| Hypotension needing treatment | ||||||
| Colman16 | 1/27 | 0/15 | 1.71 | 0.07 to 39.65 | 0.03 to 106.39 | |
| Cucchiara17 | 5/37 | 5/37 | 1.00 | 0.32 to 3.17 | 0.22 to 4.55 | |
| Gibson21 | 1/21 | 0/19 | 2.73 | 0.12 to 63.19 | 0.04 to 169.63 | |
| Stone22 | 12/89 | 2/39 | 2.63 | 0.62 to 11.20 | 0.39 to 17.65 | |
| Miller27 | 1/30 | 0/15 | 1.55 | 0.07 to 35.89 | 0.02 to 96.36 | |
| Miller28 | 39/368 | 19/180 | 1.00 | 0.60 to 1.69 | 0.51 to 1.98 | |
| Davies29 | 6/20 | 11/20 | 0.55 | 0.25 to 1.19 | 0.20 to 1.52 | |
| Wallace31 | 13/99 | 13/101 | 1.02 | 0.50 to 2.09 | 0.40 to 2.62 | |
| Bayliff32 | 24/49 | 13/50 | 1.88 | 1.09 to 3.26 | 0.92 to 3.87 | |
| Yang37 | 114/246 | 84/250 | 1.38 | 1.11 to 1.72 | 1.03 to 1.84 | |
| Total | 216/986 | 147/726 | 1.27 | 1.04 to 1.56 | 0.97 to 1.66 | 6% |
| Bradycardia needing treatment | ||||||
| Cucchiara17 | 0/37 | 1/37 | 0.33 | 0.01 to 7.93 | 0.01 to 21.46 | |
| Liu19 | 0/16 | 1/14 | 0.29 | 0.01 to 6.69 | 0.00 to 17.86 | |
| Magnusson20 | 4/15 | 0/15 | 9.00 | 0.53 to 153.79 | 0.22 to 375.21 | |
| Stone22 | 10/89 | 0/39 | 9.33 | 0.56 to 155.41 | 0.23 to 376.09 | |
| McKenzie23 | 1/50 | 0/50 | 3.00 | 0.13 to 71.92 | 0.05 to 195.17 | |
| Jakobsen26 | 5/49 | 1/49 | 5.00 | 0.61 to 41.25 | 0.31 to 80.06 | |
| Davies29 | 12/20 | 8/20 | 1.50 | 0.79 to 2.86 | 0.64 to 3.50 | |
| Wallace31 | 2/99 | 1/101 | 2.04 | 0.19 to 22.14 | 0.09 to 46.84 | |
| Yang37 | 53/246 | 19/250 | 2.83 | 1.73 to 4.64 | 1.48 to 5.42 | |
| Total | 87/621 | 31/575 | 2.27 | 1.53 to 3.36 | 1.36 to 3.80 | 3% |
| Bronchospasm | ||||||
| Cucchiara17 | 1/37 | 0/37 | 3.00 | 0.13 to 71.34 | 0.05 to 193.10 | |
| Jakobsen18 | 1/10 | 0/10 | 3.00 | 0.14 to 65.90 | 0.05 to 173.99 | |
| MacKenzie23 | 0/50 | 1/50 | 0.33 | 0.01 to 7.99 | 0.01 to 21.69 | |
| Inada24 | 1/20 | 1/10 | 0.50 | 0.03 to 7.19 | 0.02 to 16.62 | |
| Leslie25 | 1/40 | 2/20 | 0.25 | 0.02 to 2.59 | 0.01 to 5.41 | |
| Jakobsen26 | 1/49 | 1/49 | 1.00 | 0.06 to 15.54 | 0.03 to 36.80 | |
| Miller28 | 4/368 | 2/180 | 0.98 | 0.18 to 5.29 | 0.11 to 8.99 | |
| Jakobsen30 | 1/18 | 1/18 | 1.00 | 0.07 to 14.79 | 0.03 to 34.47 | |
| Wallace31 | 3/99 | 0/101 | 7.14 | 0.37 to 136.46 | 0.15 to 344.84 | |
| Bayliff32 | 12/49 | 16/50 | 0.77 | 0.41 to 1.45 | 0.33 to 1.77 | |
| Yang37 | 4/246 | 1/250 | 4.07 | 0.46 to 36.11 | 0.23 to 71.74 | |
| Total | 29/986 | 25/775 | 0.91 | 0.55 to 1.50 | 0.47 to 1.75 | 0% |
NA=not applicable.
*
Composite outcome of cardiovascular death, non-fatal myocardial Infarction, and non-fatal cardiac arrest.