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Safety of intravenous metoprolol use in unmonitored wards: a single‐centre observational study
Author(s) -
Kelly D.,
Hawdon G.,
Reeves J.,
Morris A.,
Cunningham M.,
Barrett J.
Publication year - 2015
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/imj.12842
Subject(s) - medicine , metoprolol , confidence interval , observational study , emergency medicine , retrospective cohort study , emergency department , adverse effect , population , complication , anesthesia , environmental health , psychiatry
Background and Aim This study aims to examine and quantify the risks associated with the use of intravenous metoprolol on unmonitored wards. Method This study was a retrospective single‐centre observational study from 1 J anuary 2009 to 31 D ecember 2013. The study hospital was a 415‐bed, private hospital in M elbourne, V ictoria. The study population was all patients who received intravenous metoprolol on an unmonitored ward. The primary outcome measure was the rate of serious adverse events ( SAE ), defined as a complication of intravenous metoprolol resulting in transfer to a critical‐care environment, a medical emergency team call or death.Results Six hundred and nine patients received a total of 8260 doses of intravenous metoprolol. Seven cases were identified with a SAE deemed possibly related to beta‐blocker use and there was one death. All SAE were hypotension, giving an overall rate of hypotension of 7/609 or 1.1% (95% confidence interval ( CI ), 0.5 to 2.4%) with a rate per dose delivered of 0.8/1000 doses (95% CI 0.3 to 1.7). The death occurred in a 94‐year‐old woman with abdominal sepsis. After case file review, consensus opinion deemed this to be unrelated to intravenous metoprolol. Conclusion The use of intravenous metoprolol on unmonitored wards appears to be safe. The complication rate was low, suggesting that this may be a sensible approach to the management of in‐hospital populations at risk of beta‐blocker withdrawal.