Research Reports - Therapeutic effect of beta-blocker in patients with traumatic brain injury

J Crit Care. 2017 May 31;41:240-246. doi: 10.1016/j.jcrc.2017.05.035. [Epub ahead
of print]

Chen Z(1), Tang L(2), Xu X(1), Wei X(1), Wen L(1), Xie Q(3).

OBJECTIVE: β-Blocker exposure has been shown to reduce mortality in traumatic
brain injury (TBI); however, the efficacy of β-blockers remains inconclusive.
Therefore, a meta-analysis was conducted in this paper to evaluate the safety and
efficacy of β-blocker therapy on patients with TBI.
METHODS: The electronic databases were systemically retrieved from construction
to February 2017. The odds ratio (OR), mean difference (MD) and 95% confidence
intervals (CI) were determined.
RESULTS: A total of 13 observational cohort studies involving 15,734 cases were
enrolled. The results indicated that β-blocker therapy had remarkably reduced the
in-hospital mortality (OR 0.33; 95% CI 0.27-0.40; p<0.001). However, β-blocker
therapy was also associated with increased infection rate (OR 2.01; 95% CI
1.50-2.69; p<0.001), longer length of stay (MD=7.40; 95% CI=4.39, 10.41; p<0.001)
and ICU stay (MD=3.52; 95% CI=1.56, 5.47; p<0.001). In addition, β-blocker
therapy also led to longer period of ventilator support (MD=2.70; 95% CI=1.81,
3.59; p<0.001).
CONCLUSION: The meta-analysis demonstrates that β-blockers are effective in
lowering mortality in patients with TBI. However, β-blocker therapy has markedly
increased the infection rate and requires a longer period of ventilator support,
intensive care management as well as length of stay.

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