Beta‐Blocker Therapy in Severe Traumatic Brain Injury: A Prospective Randomized Controlled Trial

• DOI: 10.1007/s00268-020-05391-8
• Publication Date: 2020-01-30T19:03:26Z
• Authors: Hosseinali Khalili; Rebecka Ahl; Shahram Paydar; Gabriel Sjolin; Yang Cao; Hossein Abdolrahi...; Amin Niakan; Kamil Hanna; Bellal Joseph; Shahin Mohseni
• Keywords: Glasgow Outcome Scale

Abstract Background Observational studies have demonstrated improved outcomes in TBI patients receiving in‐hospital beta‐blockers. The aim of this study is to conduct a randomized controlled trial examining the effect beta‐blockers on patients. Methods Adult with severe (intracranial AIS ≥ 3) were included study. Hemodynamically stable at 24 h after injury receive either 20 mg propranolol orally every 12 up 10 days or until discharge (BB+) no (BB−). Outcomes interest mortality and Glasgow Outcome Scale‐Extended (GOS‐E) score 6‐month follow‐up. Subgroup analysis including only isolated 3 extracranial ≤ 2) was carried out. Poisson regression models used. Results Two hundred nineteen whom 45% received BB analyzed. There significant demographic clinical differences between + − cohorts. No difference (adj. IRR 0.6 [95% CI 0.3–1.4], p = 0.2) long‐term functional outcome measured cohorts ( 0.3). One fifty‐four suffered 44% BB. group had significantly lower relative (18.6% vs. 4.4%, 0.012). On analysis, protective 0.32, 0.04) follow‐up (GOS‐E 5 adj. 1.2, 0.02). Conclusion Propranolol decreases improves TBI. This speaks favor routine administration beta‐blocker therapy as part standardized neurointensive care protocol. Level evidence II; therapeutic. Study type Therapeutic