| Beta-blocker use is associated with improved outcomes in adult burn patients. | |
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MedLine Citation:
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PMID: 14960966 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: There is no direct evidence that beta-blockers improve mortality in burn victims. Beta-blockers attenuate hypermetabolic states in burned children, and perioperative use in elective adult cases has beneficial effects, which suggests that beta-blockers may also improve burn outcomes. However, beta-blockers decrease cardiac output and may decrease oxygen delivery, and theoretically may increase mortality. What is the effect of beta-blockers on healing time and mortality in burn patients? METHODS: This was a retrospective cohort study. We identified three cohorts of adult burn patients between 1996 and 2001: all who were on beta-blockers (BB) before their injury (PMH BB); all who were initiated on BB during their hospitalization for management of hypertension or tachyarrhythmia (HOSP BB); and control, who were never treated with beta-blockers. For each patient in the PMH BB and HOSP BB groups, two patients were placed in the control cohort by matching age and total body surface area burn. Premorbid conditions such as diabetes, hypertension, cardiac disease, renal insufficiency, and diuretic and calcium channel blocker use were analyzed. Multivariate regression models were used to identify independent modifiers. RESULTS: There were 21 PMH BB, 22 HOSP BB, and 86 control patients. All PMH BB patients remained on their BB regimen in the hospital. HOSP BB patients were initiated on beta-blockers at a mean of 8.8 days postinjury. There were no differences in age (mean, 58 +/- 17 years), total body surface area burned (mean, 14 +/- 12%), or mechanism of injury among the cohorts. The mortality rate was 5% for the PMH BB cohort, 27% for the HOSP BB cohort, and 13% for controls. The mean healing times were 51 +/- 29 days for PMH BB patients, 79 +/- 54 days for HOSP BB patients, and 60 +/- 39 for controls. In multivariate analyses, PMH BB was associated with a significant decrease in fatal outcome and healing time (p < or = 0.05 compared with control). CONCLUSION: Beta-blockers have the potential to improve adult burn outcomes. Postinjury treatment should be studied in a randomized, clinical trial. |
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Authors:
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Saman Arbabi; Karla S Ahrns; Wendy L Wahl; Mark R Hemmila; Stewart C Wang; Mary-Margaret Brandt; Paul A Taheri |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Journal of trauma Volume: 56 ISSN: 0022-5282 ISO Abbreviation: J Trauma Publication Date: 2004 Feb |
Date Detail:
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Created Date: 2004-02-12 Completed Date: 2004-03-18 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0376373 Medline TA: J Trauma Country: United States |
Other Details:
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Languages: eng Pagination: 265-9; discussion 269-71 Citation Subset: AIM; IM |
Affiliation:
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Department of Surgery, University of Michigan health System, Ann Arbor, Michigan 48109-0033, USA. sarbabi@umich.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic beta-Antagonists
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therapeutic use* Aged Burns / drug therapy*, epidemiology, mortality Comorbidity Heart Rate / drug effects Humans Length of Stay Middle Aged Retrospective Studies Treatment Outcome Wound Healing / drug effects* |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic beta-Antagonists |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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