Gao Bin, Wang Anxin, Zhang Xiaoli, Zhang Jia, Ju Yi, Zhao Xingquan, Wang Wenjuan
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.
China National Clinical Research Center for Neurological Diseases, Beijing, People's Republic of China.
J Inflamm Res. 2025 Jul 17;18:9355-9364. doi: 10.2147/JIR.S511889. eCollection 2025.
Given the current lack of research on the impact of beta-blockers (BB) on clinical outcomes in patients with intracerebral hemorrhage (ICH). This study aimed to evaluate the effect of BB on pneumonia, functional outcomes, and mortality in adult patients with primary ICH.
This was a retrospective study of a registry cohort of patients with ICH from 13 stroke centers in Beijing, China. Patients aged 18 years or older with first-time primary ICH admitted within 72 h after onset were included. Main exclusion criteria including previous ICH, previous mRS≥3, primary intraventricular hemorrhage, missing of baseline data or lost of follow-up. BB group was defined as any use of beta-blockers pre-existing or initiated after onset of ICH, those without any use of beta-blockers were defined as non-BB group. The clinical outcomes were in-hospital pneumonia, mortality and functional outcome (favorable outcome defined as a modified Rankin Score of 0-3) at 90 d.
The study included 947 patients (657 males [69.38%]; mean [standard deviation] age, 57.67 [13.68] years). Two hundred and thirty of 809 patients (28.43%) in the non-BB group and 64 of 138 patients in the BB group were diagnosed with pneumonia (46.38%). Multivariate analysis confirmed that patients in the BB group were likely to have an increased risk of pneumonia after adjusting for confounders (odds ratio [OR], 1.806; 95% confidence interval [CI]:1.139-2.862; P=0.0119). No statistical difference was observed in the proportion of favorable outcome (P=0.9289) or mortality (P=0.2120) at 90 d between the two groups.
The results of this cohort study suggest that any use of BB is associated with an increased risk of pneumonia post-ICH. Randomized clinical trials are needed to evaluate the effects of non-selective BB on the prevention of pneumonia post-ICH.
鉴于目前关于β受体阻滞剂（BB）对脑出血（ICH）患者临床结局影响的研究匮乏，本研究旨在评估BB对成年原发性ICH患者肺炎、功能结局及死亡率的影响。
这是一项对来自中国北京13个卒中中心的ICH患者登记队列的回顾性研究。纳入发病72小时内首次发生原发性ICH且年龄在18岁及以上的患者。主要排除标准包括既往有ICH、既往改良Rankin量表（mRS）评分≥3、原发性脑室出血、基线数据缺失或失访。BB组定义为ICH发病前已使用或发病后开始使用任何β受体阻滞剂的患者，未使用任何β受体阻滞剂的患者定义为非BB组。临床结局为90天时的院内肺炎、死亡率及功能结局（良好结局定义为改良Rankin评分0 - 3分）。
本研究纳入947例患者（657例男性[69.38%]；平均[标准差]年龄57.67[13.68]岁）。非BB组809例患者中有230例（28.43%）被诊断为肺炎，BB组138例患者中有64例（46.38%）被诊断为肺炎。多因素分析证实，校正混杂因素后，BB组患者发生肺炎的风险可能增加（比值比[OR]，1.806；95%置信区间[CI]：1.139 - 2.862；P = 0.0119）。两组在90天时良好结局比例（P = 0.9289）或死亡率（P = 0.2120）方面未观察到统计学差异。
该队列研究结果表明，任何BB的使用均与ICH后肺炎风险增加相关。需要进行随机临床试验以评估非选择性BB对预防ICH后肺炎的效果。
