Department of Neurocritical Care, Latinamerican Council of Neurocritical Care, Cartagena, Colombia.
Department of Pediatry, El Bosque University, Bogota, Colombia.
Neurol Res. 2021 Aug;43(8):609-615. doi: 10.1080/01616412.2020.1866385. Epub 2021 Jan 22.
Systematically review the medical literature for the impact of beta-blockers on mortality and functional capacity in patients who suffered severe traumatic brain injury.
The search included MEDLINE, EMBASE, and Ovid Evidence-Based Medicine, clinical trial registries, and bibliographies.
All articles that reported outcome in TBI patients treated with beta-blockers.
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.
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).
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.
CI: confidence interval; BB: Beta-Blockers; OR = odds ratio; TBI: Traumatic Brain Injury SD: Standard deviation; SNS: Sympathetic nervous system.
系统回顾医学文献中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。
检索了 MEDLINE、EMBASE 和 Ovid 循证医学、临床试验注册处和参考文献。
所有报告β受体阻滞剂治疗 TBI 患者结局的文章。
出版年份、患者数量、结局和随访。对于有足够数据估计均数差异的每个变量，我们进行了荟萃分析。
纳入 12 项研究，涉及 14057 例回顾性和前瞻性收集数据的患者。与对照组相比，β受体阻滞剂治疗组患者死亡率降低（OR 0.40，95%CI 0.30-0.54，p<0.00001），研究间存在可接受的异质性（I2=65%，p=0.00008）。β受体阻滞剂治疗降低了不良神经和功能结局的风险（OR 0.59，95%CI 0.38-0.92，p<0.00001），纳入研究间存在很高的统计学异质性（I2=80%，p=0.00004），可能影响结果。显示有利的神经和功能结局增加（OR 1.19，95%CI 1.07-1.31，p=0.001），具有可接受的异质性（I2=52%，p=0.08）。
β受体阻滞剂治疗与 TBI 患者的结局显著改善相关。在 TBI 患者中使用β受体阻滞剂是神经创伤的一个有前途的领域。
CI：置信区间；BB：β受体阻滞剂；OR=比值比；TBI：创伤性脑损伤；SD：标准差；SNS：交感神经系统。
