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In the landmark POISE trial, patients who started β-blockers several hours before noncardiac surgery were more likely to die than patients who received placebo (JW Gen Med May 22 2008). However, that trial excluded patients who had received long-term β-blocker therapy prior to surgery.
In the Surgical Care and Outcomes Assessment Program, a quality-improvement initiative that involves most hospitals in Washington State, researchers have been collecting perioperative data prospectively — including information on β-blocker use. In 2008 and 2009, nearly 2000 patients who had received outpatient β-blocker therapy underwent colorectal or bariatric surgery at participating hospitals. In 66% of patients, β-blockers were continued on the day of surg…