title: Beta-blocker exposure in the absence of significant head injuries is associated with reduced mortality in critically ill patients.
abstract: BACKGROUND
  The effect of β-blockade in trauma patients without significant head injuries is unknown. The purpose of this investigation was to determine the impact of β-blocker exposure on mortality in critically injured trauma patients who did not sustain significant head injuries.
  
  
  METHODS
  Critically ill trauma patients (Injury Severity Score ≥ 25) admitted to the surgical intensive care unit from January 2000 to December 2008 without severe traumatic brain injuries (head Abbreviated Injury Score ≥ 3) were included in this retrospective review. Patients who received β-blockers within 30 days of intensive care unit admission were compared with those who did not. The primary outcome measure evaluated was in-hospital mortality.
  
  
  RESULTS
  During the 9-year study period, 663 critically injured patients (Injury Severity Score ≥ 25) were admitted to the intensive care unit. Of these, 98 patients (14.8%) received β-blockers. Patients exposed to β-blockers had significantly lower in-hospital mortality (11.2% vs 19.3%, P = .006). Stepwise logistic regression identified β-blocker use as an independent protective factor for mortality (adjusted odds ratio, .37; P = .007) in critically injured patients.
  
  
  CONCLUSIONS
  Beta-blocker exposure was associated with reduced mortality in critically injured patients without head injuries. Prospective validation of this finding is warranted.
authors.affiliation: Department of Surgery, Division of Trauma and Surgical Critical Care, Cedars-Sinai Medical Center, Los Angeles, CA, USA. marko.bukur@cshs.org
authors.forename: Marko
authors.initials: M
authors.lastname: Bukur
authors.forename: Thomas
authors.initials: T
authors.lastname: Lustenberger
authors.forename: Bryan
authors.initials: B
authors.lastname: Cotton
authors.forename: Saman
authors.initials: S
authors.lastname: Arbabi
authors.forename: Peep
authors.initials: P
authors.lastname: Talving
authors.forename: Ali
authors.initials: A
authors.lastname: Salim
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Ley
authors.forename: Kenji
authors.initials: K
authors.lastname: Inaba
mesh_terms: D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D001930:Brain Injuries; D016638:Critical Illness; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D055815:Young Adult
chemical_list: D000319:Adrenergic beta-Antagonists