دورية أكاديمية
Association of Discontinuing Preinjury Beta-Adrenergic Blockade Medications With Mortality in Severe Blunt Traumatic Brian Injury
| العنوان: | Association of Discontinuing Preinjury Beta-Adrenergic Blockade Medications With Mortality in Severe Blunt Traumatic Brian Injury |
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| المؤلفون: | Tignanelli, Christopher J, Arbabi, Saman, Iskander, Gaby, Kralovich, Kurt A, Scott, John, Sangji, Naveen F, Hemmila, Mark R |
| المصدر: | Surgery Articles |
| بيانات النشر: | Henry Ford Health Scholarly Commons |
| سنة النشر: | 2023 |
| المجموعة: | Henry Ford Health System Scholarly Commons |
| الوصف: | BACKGROUND: Beta-adrenergic receptor blocker (BB) administration has been shown to improve survival after traumatic brain injury (TBI). However, studies to date that observe a benefit did not distinguish between continuation of preinjury BB versus de novo initiation of BB. OBJECTIVES: To determine the effect of continuation of preinjury BB and de novo initiation of BB on risk-adjusted mortality and complications for patients with TBI. METHODS: Trauma quality collaborative data (2016-2021) were analyzed. Patients were excluded with hospitalization <48 >hours, direct admission, or penetrating injury. Severe TBI was identified as a head abbreviated injury scale (AIS) value of 3 to 5. Patients were placed into 4 groups based on the preinjury BB use and administration of BB during hospitalization. Propensity score matching was used to create 1:1 matched cohorts of patients for comparisons. Odd ratios of mortality accounting for hospital clustering were calculated. A sensitivity analysis was performed excluding patients with AIS >2 injuries in all other body regions to create a cohort of isolated TBI patients. RESULTS: A total of 15,153 patients treated at 35 trauma centers were available for analysis. Patients were divided into 4 cohort groupings related to preinjury BB use and postinjury receipt of BB. The odds of mortality was significantly reduced for patients with a TBI on a preinjury BB who had the medication continued in the acute setting (as compared with patients on preinjury BB who did not) (odds ratio [OR], 0.73; 95% confidence interval [CI], 0.54-0.98; P = 0.04). Patients with a TBI who were not on preinjury BB did not benefit from de novo initiation of BB with regard to mortality (OR, 0.83; 95% CI, 0.64-1.08; P = 0.2). In the sensitivity analysis, excluding polytrauma patients, patients on preinjury BB who had BB continued had a reduction in mortality when compared with patients in which BB was stopped following a TBI (OR, 0.65; 95% CI, 0.47-0.91; P = 0.01). CONCLUSIONS: Continuing BB is ... |
| نوع الوثيقة: | text |
| وصف الملف: | application/pdf |
| اللغة: | unknown |
| العلاقة: | https://scholarlycommons.henryford.com/surgery_articles/714Test; https://scholarlycommons.henryford.com/context/surgery_articles/article/1711/viewcontent/association_of_discontinuing_preinjury.30.pdfTest |
| الإتاحة: | https://scholarlycommons.henryford.com/surgery_articles/714Test https://scholarlycommons.henryford.com/context/surgery_articles/article/1711/viewcontent/association_of_discontinuing_preinjury.30.pdfTest |
| رقم الانضمام: | edsbas.F9E97C25 |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |