Zaifeng Chen1, Linjun Tang2, Xinlong Xu1, Xiaojie Wei1, Lutong Wen1, Qingsong Xie3. 1. Department of Neurosurgery, Wenzhou Medical University Affiliated Cixi Hospital, Cixi, Zhejiang, PR China. 2. Department of Neurosurgery, Tongling Municipal Hospital, Tongling, Anhui, PR China. 3. Department of Neurosurgery, Wenzhou Medical University Affiliated Cixi Hospital, Cixi, Zhejiang, PR China. Electronic address: qsxie@163.com.
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.
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.
Authors: Mathijs R Wirtz; Jiri Moekotte; Kirsten Balvers; Marjolein M Admiraal; Jean-Francois Pittet; Joe Colombo; Brant M Wagener; J Carel Goslings; Nicole Juffermans Journal: Intensive Care Med Exp Date: 2020-11-25