ABSTRACT

Objectives

Systematically review the medical literature for the impact of beta-blockers on mortality and functional capacity in patients who suffered severe traumatic brain injury.

Data Sources

The search included MEDLINE, EMBASE, and Ovid Evidence-Based Medicine, clinical trial registries, and bibliographies.

Study Selection

All articles that reported outcome in TBI patients treated with beta-blockers.

Data Extraction

Publication year, number of patients, outcome and follow-up. We performed a meta-analysis for each variable for which there were sufficient data to estimate mean differences.

Data Synthesis

12 studies were included, which involved retrospectively and prospectively collected data on 14,057 patients. The treatment with beta-blockers was associated with a reduction in mortality in patients who were treated with beta-blockers compared to the control group (OR 0.40, 95% CI 0.30–0.54p = <0.00001), with acceptable heterogeneity between studies (I2 = 65% p = 0.00008). Beta-blocker therapy decreases the risk of negative neurological and functional outcomes (OR 0.59, 95% CI 0.38–0.92 p = <0.00001), a very high statistical heterogeneity between the included studies (I2 = 80% p = 0.00004), being able to influence the results. An increase in favorable neurological and functional outcomes is shown (OR 1.19, 95% CI 1.07–1.31 p = 0.001) with acceptable heterogeneity (I2 = 52% p = 0.08)

Conclusions

The beta-blockers therapy is associated with significantly improves outcome in patients with TBI. Treatment with beta-blockers in patients with TBI is a promising frontier in neurotrauma.

Abbreviations

CI: confidence interval; BB: Beta-Blockers; OR = odds ratio; TBI: Traumatic Brain Injury SD: Standard deviation; SNS: Sympathetic nervous system

中文翻译：

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β受体阻滞剂在严重创伤性脑损伤中作用的系统评价和荟萃分析

摘要

目标

系统回顾医学文献，了解 β 受体阻滞剂对严重创伤性脑损伤患者死亡率和功能能力的影响。

数据源

搜索包括 MEDLINE、EMBASE 和 Ovid 循证医学、临床试验注册和参考书目。

研究选择

所有报道使用 β 受体阻滞剂治疗的 TBI 患者的结果的文章。

数据提取

出版年份、患者人数、结果和随访。我们对每个有足够数据来估计平均差异的变量进行了荟萃分析。

数据综合

纳入了 12 项研究，涉及回顾性和前瞻性收集的 14,057 名患者的数据。与对照组相比，β受体阻滞剂治疗与接受β受体阻滞剂治疗的患者死亡率降低相关（OR 0.40, 95% CI 0.30–0.54p = <0.00001），研究之间的异质性可接​​受（I2 = 65% p = 0.00008）。β-受体阻滞剂治疗降低了负面神经和功能结果的风险（OR 0.59, 95% CI 0.38–0.92 p = <0.00001），纳入研究之间的统计学异质性非常高（I2 = 80% p = 0.00004），能够来影响结果。显示出有利的神经和功能结果增加（OR 1.19, 95% CI 1.07–1.31 p = 0.001），异质性可接​​受（I2 = 52% p = 0.08）

结论

β-受体阻滞剂治疗与显着改善 TBI 患者的预后有关。在 TBI 患者中使用 β 受体阻滞剂治疗是神经外伤的一个有前途的前沿领域。

缩写

CI：置信区间；BB：β-受体阻滞剂；OR = 优势比；TBI：创伤性脑损伤 SD：标准差；SNS：交感神经系统