ResultsPatient characteristics and mortalityA total of 314 ICU patients (median age 70 IQR (62 to 79) years) with acute respiratory failure were analyzed in the present study. Patient characteristics are displayed in selleck screening library Table Table1.1. Final discharge diagnoses are displayed in Table Table2.2. ICU median (range) length of stay (LOS) was 3 (2 to 4) days and median in-hospital LOS 14 (9 to 22) days. Overall in-hospital mortality was 16% (51 patients), 30-day mortality was 20% (61 patients) and one-year mortality was 41% (128 patients).Table 1Baseline characteristics of study populationTable 2Final discharge diagnoses of studied patientsRisk factors of one-year and in-hospital mortalityUnivariate analysis demonstrates that age, a history of CAD or malignancy, BMI, diastolic blood pressure, atrial fibrillation, creatinine, blood urea nitrogen (BUN) or uric acid levels as well as treatment with oral steroids at discharge were associated with an increased risk of one-year mortality (Table (Table3).
3). By contrast, treatment with oral beta-blockers, statins, aspirin and/or clopidogrel at admission, as well as ACEi/ARB at discharge was associated with a lower risk for one-year mortality. Multivariate analysis shows that history of CAD or history of malignancy was associated with an increased risk and oral beta-blocker treatment prior to admission with a decreased risk of one-year mortality (Table (Table44).Table 3Predictors of one-year mortality by univariate analysis (n = 314)Table 4Independent predictors of in-hospital and one-year mortality by multivariate analysisUnivariate analysis shows that a history of malignancy, BMI, atrial fibrillation and creatinine levels on admission were associated with an increased risk of in-hospital mortality.
By contrast, treatment with oral beta-blockers prior to admission was associated with a lower risk of in-hospital mortality. Multivariate analysis shows that history of malignancy was associated with an increased risk and oral beta-blocker treatment prior to admission with a decreased risk of in-hospital mortality in ICU patients with acute respiratory failure (Table (Table44).Impact of oral beta-blockers on short and long term outcomeTable Table55 displays the different beta-blocker agents and the mean dosage administered during hospitalization.
Kaplan-Meier Carfilzomib analysis confirmed a lower in-hospital and one-year mortality in ARF patients admitted with than without oral beta-blockers (P = 0.001 for in-hospital and P < 0.001 for one-year mortality respectively) (Figure (Figure1).1). The beneficial effect of oral beta-blockers at admission on one-year mortality holds true in the two subgroups of ARF related to cardiac or non-cardiac causes (Figure (Figure11).Table 5Different agents and mean dosages of beta-blocker administered at presentation, at 24 hours and at dischargeFigure 1Impact of beta-blocker at admission on long-term outcome.