Citation

Chen Z, Tang L, Xu X, Wei X, Wen L, Xie Q. J. Crit. Care 2017; 41: 240-246.

Affiliation

Department of Neurosurgery, Wenzhou Medical University Affiliated Cixi Hospital, Cixi, Zhejiang, PR China. Electronic address: qsxie@163.com.

Copyright

(Copyright © 2017, Elsevier Publishing)

DOI

10.1016/j.jcrc.2017.05.035

PMID

28595083

Abstract

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.

Copyright © 2017 Elsevier Inc. All rights reserved.

Language: en

Keywords

Beta-blocker; Catecholamine; Meta-analysis; Traumatic brain injury