Beta-blockers and Traumatic Brain Injury: A Systematic Review, Meta-analysis, and Eastern Association for the Surgery of Trauma Guideline

Annals of Surgery
Aziz S AlaliMayur B Patel

Abstract

To determine if beta-(β)-blockers improve outcomes after acute traumatic brain injury (TBI). There have been no new inpatient pharmacologic therapies to improve TBI outcomes in a half-century. Treatment of TBI patients with β-blockers offers a potentially beneficial approach. Using MEDLINE, EMBASE, and CENTRAL databases, eligible articles for our systematic review and meta-analysis (PROSPERO CRD42016048547) included adult (age ≥ 16 years) blunt trauma patients admitted with TBI. The exposure of interest was β-blocker administration initiated during the hospitalization. Outcomes were mortality, functional measures, quality of life, cardiopulmonary morbidity (e.g., hypotension, bradycardia, bronchospasm, and/or congestive heart failure). Data were analyzed using a random-effects model, and represented by pooled odds ratio (OR) with 95% confidence intervals (CI) and statistical heterogeneity (I). Data were extracted from 9 included studies encompassing 2005 unique TBI patients with β-blocker treatment and 6240 unique controls. Exposure to β-blockers after TBI was associated with a reduction of in-hospital mortality (pooled OR 0.39, 95% CI: 0.27-0.56; I = 65%, P < 0.00001). None of the included studies examined functional outcome o...Continue Reading

References

Sep 1, 1983·Journal of Neurosurgery·C S RobertsonR G Grossman
Jun 28, 1997·BMJ : British Medical Journal·P Alderson, I Roberts
Aug 27, 1999·BMJ : British Medical Journal·B GregsonR P Sengupta
Nov 5, 1999·Critical Care Medicine·C S RobertsonR G Grossman
Feb 24, 2001·Journal of Neurology, Neurosurgery, and Psychiatry·D DoE Bromfield
Apr 13, 2001·Acta Anaesthesiologica Scandinavica·S NarediL O Koskinen
Jan 12, 2007·The Journal of Trauma·Bryan A CottonJohn A Morris
Jan 12, 2007·The Journal of Trauma·Saman ArbabiWendy L Wahl
Dec 13, 2007·The Journal of Trauma·William P RiordanJohn A Morris
Jan 12, 2008·The Journal of Trauma·Ali SalimDemetrios Demetriades
Mar 1, 2008·Journal of the American College of Surgeons·Kenji InabaDemetrios Demetriades
Apr 26, 2008·BMJ : British Medical Journal·Gordon H GuyattUNKNOWN GRADE Working Group
May 10, 2008·BMJ : British Medical Journal·Gordon H GuyattUNKNOWN GRADE Working Group
Oct 3, 2008·Neurosurgical Focus·Timothy Y TranJohn W German
Nov 13, 2008·The Journal of Trauma·Todd NeideenKaren J Brasel
Aug 29, 2009·Current Opinion in Critical Care·David K Menon, Cameron Zahed
Nov 21, 2009·Journal of the American College of Cardiology·Kirsten E FleischmannR James Valentine
Jul 6, 2010·The Journal of Surgical Research·Eric J LeyAli Salim
Oct 13, 2010·The Journal of Trauma·Thomas J SchroeppelMartin A Croce
Nov 4, 2010·The Journal of Trauma·Daithi S HeffernanBryan A Cotton
Mar 26, 2011·The New England Journal of Medicine·D James CooperUNKNOWN Australian and New Zealand Intensive Care Society Clinical Trials Group
Jun 18, 2011·The American Surgeon·Pantelis HadjizachariaPeter Rhee
Sep 22, 2011·Journal of Neurotrauma·David M PanczykowskiDavid O Okonkwo
Sep 24, 2011·Injury·Cherisse BerryAli Salim
Oct 20, 2011·BMJ : British Medical Journal·Julian P T HigginsUNKNOWN Cochrane Statistical Methods Group
Apr 12, 2012·The Journal of Trauma and Acute Care Surgery·Marko BukurKenji Inaba
Nov 9, 2012·The Journal of Trauma and Acute Care Surgery·Andrew J KerwinUNKNOWN Eastern Association for the Surgery of Trauma Practice Management Guidelines Ad Hoc Committee
Sep 26, 2013·Neurocritical Care·Aziz S AlaliAvery B Nathens
Sep 26, 2013·Journal of Neurosurgical Anesthesiology·Pia Löwhagen HendénAnders Aneman
Oct 11, 2013·JAMA : the Journal of the American Medical Association·Andrea MorelliMervyn Singer
Nov 5, 2013·Journal of the Neurological Sciences·J P ShoupL H Sansing
Nov 12, 2013·Brain Injury : [BI]·John J RadosevichBrian L Erstad
Jan 25, 2014·The Journal of Trauma and Acute Care Surgery·Thomas J SchroeppelTimothy C Fabian

❮ Previous
Next ❯

Citations

May 16, 2018·Critical Care Medicine·Christos Lazaridis
Sep 5, 2017·Acta Neurologica Scandinavica·M SykoraD Strbian
Sep 28, 2018·The British Journal of Surgery·R AhlS Mohseni
Aug 8, 2018·Der Anaesthesist·C J ReußT Brenner
Aug 20, 2019·The Journal of Trauma and Acute Care Surgery·Muhammad ZeeshanBellal Joseph
Aug 31, 2019·Trauma Surgery & Acute Care Open·Thomas J SchroeppelTimothy C Fabian
Dec 19, 2017·The Journal of Trauma and Acute Care Surgery·Eric J LeyUNKNOWN Beta Blockers TBI Study Group Collaborators
Aug 26, 2020·The American Surgeon·Thomas J SchroeppelTimothy C Fabian
Sep 12, 2020·Seminars in Respiratory and Critical Care Medicine·Shayan RakhitMayur B Patel
Jun 18, 2019·Current Surgery Reports·Henry W Caplan, Charles S Cox
Feb 1, 2020·World Journal of Surgery·Hosseinali KhaliliShahin Mohseni
Jan 30, 2020·Neurocritical Care·Aravind V RameshMatt Thomas
Dec 22, 2020·Journal of the American College of Surgeons·Benjamin R ZambettiLouis J Magnotti
Jul 14, 2020·Anaesthesia Critical Care & Pain Medicine·Ségolène MrozekThomas Geeraerts
Jan 23, 2021·Neurological Research·William A Florez-PerdomoLuis Rafael Moscote-Salazar
Jan 27, 2021·Trends in Neurosciences·Alan I FadenRebecca J Henry
Dec 18, 2020·The Journal of Trauma and Acute Care Surgery·Samer AsmarBellal Joseph
Nov 24, 2020·The Mental Health Clinician·Sophie Robert
Sep 30, 2017·The Surgical Clinics of North America·Michael A VellaMayur B Patel
Apr 14, 2021·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Shahin MohseniCarol Jane Peden
Jan 27, 2021·The Journal of Trauma and Acute Care Surgery·Huaqiang DingLiang Liu
Apr 18, 2020·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Abhijit V LeleMonica S Vavilala

❮ Previous
Next ❯

Related Concepts

Related Feeds

Brain Injury & Trauma

brain injury after impact to the head is due to both immediate mechanical effects and delayed responses of neural tissues.

Bradyarrhythmias

Bradyarrhythmias are slow heart rates. Symptoms may include syncope, dizziness, fatigure, shortness of breath, and chest pains. Find the latest research on bradyarrhythmias here.

Related Papers

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
James H BrennanBiswadev Mitra
International Angiology : a Journal of the International Union of Angiology
Hisato Takagi, Takuya Umemoto
The Journal of Cardiovascular Surgery
Hisato TakagiAll-Literature Investigation of Cardiovascular Evidence (ALICE) group
© 2022 Meta ULC. All rights reserved