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Effect of premorbid beta-blockers on cardiac function and clinical outcomes in septic patients: a retrospective study Cover

Effect of premorbid beta-blockers on cardiac function and clinical outcomes in septic patients: a retrospective study

The Journal of Critical Care Medicine
Volume 12 (2026): Issue 2 (April 2026)
By: ,  ,   and    
Open Access
|Apr 2026
Figures & tables

Figures & Tables

Fig. 1.

Levels of SOFA and APACHE II score among patients with or without premorbid beta-blocker.

Table 1.

Patient Characteristics.

Overall population (N=1005, 100%)Premorbid beta-blocker (N=228, 22.7%)No premorbid beta-blocker (N=777, 77.3%)P value
Baseline characteristics
Age, years, mean ± SD70 ± 1471 ± 1169 ± 140.203
Gender (male), n, (%)651 (64.8)157 (68.9)494 (63.6)0.142
BMI (kg/m2), mean ± SD22.8 ± 3.422.9 ± 3.622.9 ± 3.40.811
Coexisting conditions, n. (%)
Hypertension702 (69.9)194 (85.1)508 (65.4)< 0.001
Coronary heart disease73 (7.3)42 (18.4)31 (4.0)< 0.001
Heart failure57 (5.8)20 (8.8)37 (4.8)0.021
Arrhythmia80 (8.0)36 (15.8)44 (5.7)< 0.001
Valvular heart disease14 (1.3)5 (2.2)9 (1.2)0.241
Diabetes261 (26.0)70 (30.7)191 (24.6)0.064
Chronic obstructive pulmonary disease37 (3.7)8 (3.5)29 (3.7)0.875
Chronic bronchitis19 (1.9)4 (1.8)15 (1.9)0.864
Bronchiectasis10 (1.0)4 (1.8)6 (0.8)0.190
Chronic kidney disease89 (8.9)24 (10.5)65 (8.4)0.313
Cerebrovascular disease160 (15.9)46 (20.2)114 (14.7)0.046
Malignancy107 (10.6)26 (11.4)81 (10.4)0.674
Autoimmune diseases17 (1.7)2 (0.9)15 (1.9)0.278
Source of sepsis, n. (%)
Pulmonary666 (66.3)162 (71.1)504 (64.9)0.082
Intraabdominal268 (26.7)47 (20.6)221 (28.4)0.019
Urinary infections137 (13.6)33 (14.5)104 (13.4)0.674
Soft tissue infection27 (2.7)6 (2.6)21 (2.7)0.953
Bacteraemia43 (4.3)8 (3.5)34 (4.4)0.565
Other sources21 (2.1)4 (1.8)17 (2.2)0.678
Pathogen, n. (%)
Gram-positive142 (14.1)34 (14.9)108 (13.9)0.700
Gram-negative431 (42.9)110 (48.2)321 (41.3)0.063
Anaerobic bacteria7 (0.7)1 (0.4)6 (0.6)0.074
Fungus150 (14.9)43 (18.9)107 (13.8)0.058
Virus123 (12.2)33 (14.5)90 (11.6)0.242
Unknown290 (28.9)63 (27.6)227 (29.2)0.643
Vital signs
T (°C)38.3 [37.7, 39]38.2 [37.8, 38.9]38.3 [37.7, 39]0.556
HR (min−1)104 [94, 117]104 [95, 117]103 [94, 117]0.861
RR (min−1)22 [20, 25]22 [21, 26]22 [20, 25]0.251
MAP (mmHg)71.3 [64.7, 77.0]72.7 [66.7, 77.0]71.0 [64.0, 77.0]0.219
Vital lab data, median (IQR)
WBC (109/L)11.0 [7.0, 16.7]10.9 [7.3, 16.7]11.1 [6.9, 16.9]0.988
RBC (109/L)3.4 [2.8, 4.0]3.4 [2.8, 4.1]3.4 [2.8, 4.0]0.497
PLT (109/L)141.0 [79.5, 217.5]158.5 [93,229.8]134.0 [74.5, 214.0]0.038
HGB (g/L)102.0 [83.2, 120.0]102.0 [82.3, 121.8]101.0 [83.7, 120.0]0.959
CRP (mg/L)99.0 [46.1, 160.0]108.4 [52.2, 160.0]97.9 [43.8, 160.0]0.693
TBIL (umol/L)16.2 [10.7, 30.1]14.4 [10.3, 26.0]16.6 [10.9, 31.9]0.035
ALB (g/L)29.7 [26.3, 33.6]29.9 [26.4, 34.4]29.7 [26.3, 33.3]0.295
BNU (mmol/L)11.9 [7.4, 20.0]11.1 [7.1, 19.9]11.9 [7.7, 20.0]0.421
LAC (mmol/L)3.3 [2.4, 4.5]3.4 [2.4, 4.7]3.3 [2.3, 4.7]0.267
Severity, mean ± SD
SOFA score8.5 ± 3.88.3 ± 3.88.5 ± 3.80.519
APACHE II score19.0 ± 6.218.8 ± 5.919.0 ± 6.20.677

[i] T, temperature; HR, heart rate; RR, respiratory rate; MAP, mean arterial pressure; WBC, White Blood Cells; RBC, Red Blood Cells; PLT, Platelet; HGB, hemoglobin; CRP, hypersensitive C-reactive protein; TBIL, total bilirubin; ALB, albumin; BUN, blood urea nitrogen; LAC, lactic acid; SOFA score, Sequential Organ Failure Assessment score; APACHE II score, Acute Physiology and Chronic Health Evaluation II score; SD, standard deviation; IQR, interquartile range; Premorbid beta-blocker, patients with premorbid beta blocker therapy before septic episodes; No premorbid beta-blocker, patients without premorbid beta blocker therapy before septic episodes.

Table 2.

Comparison of myocardial injury markers, echocardiography and electrocardiogram abnormalities.

Premorbid beta-blocker (N=228, 22.7%)No premorbid beta-blocker (N=777, 77.3%)P value
Myocardial injury markers, median (IQR)
TnI (pg/ml)87.9 (23.4–306.0)142.0 (37.8–481.2)0.004
BNP (pg/ml)267.9 (118.1–1065.1)509.3 (184.8–1203.0)0.002
MYO (ng/ml)209.8 (100.3–600.4)283.6 (103.0–1046.0)0.053
CK (U/L)107.5 (43.3–253.0)127.0 (48.0–307.0)0.147
CKMB (U/L )28.0 (13.0–97.0)29.0 (16.0–63.0)0.077
LDH (U/L)274.0 (175.0–496.0)319.0 (229.0–456.8)0.022
Echocardiographic parameters, median (IQR)
LVEF, (%)58.0 (52.0–60.0)55.0 (50.0–60.0)0.009
LAD, (cm)3.4 (3.0–3.9)3.4 (3.1–3.9)0.243
LVEDD, (cm)4.3 (4.2–4.6)4.5 (4.3–4.8)< 0.001
RAD, (cm)3.3 (3.2–3.6)3.4 (3.3–3.7)0.035
RVD, (cm)3.4 (3.2–3.5)3.4 (3.2–3.6)0.007
PA, (cm)2.3 (2.2–2.5)2.3 (2.2–2.5)0.092
Electrocardiogram manifestations, no. (%)
Atrial fibrillation41 (18.0)113 (14.5)0.205
Premature atrial contractions27 (11.8)127 (16.3)0.097
Atrial flutter7 (3.1)26 (3.3)0.837
Atrial tachycardia3 (1.3)16 (2.1)0.469
Supraventricular tachycardia3 (1.3)7 (1.0)0.579
Premature ventricular contractions19 (8.3)66 (8.5)0.939
Ventricular tachycardia2 (0.8)10 (1.3)0.616
Atrioventricular block5 (2.2)16 (2.1)0.901
Bundle branch block41 (18.0)143 (18.4)0.885

[i] TnI, troponin I; BNP, B-type natriuretic peptide; MYO, myoglobin; CK, creatine kinase; CKMB,creatine kinase isoenzyme; LDH, lactic dehydrogenase; LVEF, left ventricular ejection fraction; LAD, left atrial diameter; LVEDD, left ventricular end diastolic diameter; RAD, right atrial diameter; RVD, right ventricular diameter; PA, pulmonary artery diameter; IQR, interquartile range. Premorbid beta-blocker, patients with premorbid beta blocker therapy before septic episodes; No premorbid beta-blocker, patients without premorbid beta blocker therapy before septic episodes.

Table 3.

Analysis of mortality between premorbid beta-blocker treated and untreated patients.

Overall population (N=1005, 100%)Premorbid beta-blocker (N=228, 22.7%)No premorbid beta-blocker (N=777, 77.3%)P value
In-hospital mortality, (%), 95%CI26.6 [23.8–29.3]18.9 [13.7–24.0]28.8 [25.6–32.0]0.003
7-day mortality, (%), 95%CI12.0 [10.0–14.1]9.2 [5.4–13.0]12.9 [10.5–15.2]0.135
14-day mortality, (%), 95%CI19.7 [17.2–22.2]13.6 [9.1–18.1]21.5 [18.6–24.4]0.008
28-day mortality, (%), 95%CI25.2 [22.5–27.9]17.5 [12.6–22.5]27.4 [24.3–30.6]0.003

[i] IQR, interquartile range; CI, confidence interval. Premorbid beta-blocker, patients with premorbid beta blocker therapy before septic episodes; No premorbid beta-blocker, patients without premorbid beta blocker therapy before septic episodes.

Fig. 2.

28-day survival rate for primary cohort.

DOI: https://doi.org/10.62838/jccm-2026-0014 | Journal eISSN: 2393-1817 | Journal ISSN: 2393-1809
Journal RSS Feed
Language: English
Page range: 271 - 280
Submitted on: Nov 1, 2025
Accepted on: Feb 12, 2026
Published on: Apr 30, 2026
Published by: University of Medicine, Pharmacy, Science and Technology of Targu Mures
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year
Keywords:
sepsis,
beta-blockers,
septic cardiomyopathy,
mortality,
intensive care unit
Related subjects:
Medicine,
Clinical medicine,
Internal medicine,
Internal medicine, other,
Surgery,
Surgery, other,
Anaesthesiology,
Emergency medicine and intensive-care medicine

© 2026 Siyu Yang, Rongyao Feng, Xiangzhou Fang, Chaojie Wei, published by University of Medicine, Pharmacy, Science and Technology of Targu Mures
This work is licensed under the Creative Commons Attribution 4.0 License.

Volume 12 (2026): Issue 2 (April 2026)
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