Association of Early Beta-Blocker Exposure and Functional Outcomes in Critically Ill Patients With Moderate to Severe Traumatic Brain Injury: A Transforming Clinical Research and Knowledge in Traumatic Brain Injury Study.
| dc.contributor.author | Kelly-Hedrick, Margot | |
| dc.contributor.author | Liu, Sunny Yang | |
| dc.contributor.author | Temkin, Nancy | |
| dc.contributor.author | Barber, Jason | |
| dc.contributor.author | Komisarow, Jordan | |
| dc.contributor.author | Manley, Geoffrey | |
| dc.contributor.author | Ohnuma, Tetsu | |
| dc.contributor.author | Colton, Katharine | |
| dc.contributor.author | Treggiari, Miriam M | |
| dc.contributor.author | Monson, Eric E | |
| dc.contributor.author | Vavilala, Monica S | |
| dc.contributor.author | Grandhi, Ramesh | |
| dc.contributor.author | Laskowitz, Daniel T | |
| dc.contributor.author | Mathew, Joseph P | |
| dc.contributor.author | Hernandez, Adrian | |
| dc.contributor.author | James, Michael L | |
| dc.contributor.author | Raghunathan, Karthik | |
| dc.contributor.author | Goldstein, Ben | |
| dc.contributor.author | Markowitz, Amy J | |
| dc.contributor.author | Krishnamoorthy, Vijay | |
| dc.date.accessioned | 2023-11-01T18:18:02Z | |
| dc.date.available | 2023-11-01T18:18:02Z | |
| dc.date.issued | 2023-09 | |
| dc.date.updated | 2023-11-01T18:17:59Z | |
| dc.description.abstract | ObjectivesWe aimed to 1) describe patterns of beta-blocker utilization among critically ill patients following moderate-severe traumatic brain injury (TBI) and 2) examine the association of early beta-blocker exposure with functional and clinical outcomes following injury.DesignRetrospective cohort study.SettingICUs at 18 level I, U.S. trauma centers in the Transforming Clinical Research and Knowledge in TBI (TRACK-TBI) study.PatientsGreater than or equal to 17 years enrolled in the TRACK-TBI study with moderate-severe TBI (Glasgow Coma Scale of <13) were admitted to the ICU after a blunt TBI.InterventionsNone.MeasurementsPrimary exposure was a beta blocker during the first 7 days in the ICU, with a primary outcome of 6-month Glasgow Outcome Scale-Extended (GOSE). Secondary outcomes included: length of hospital stay, in-hospital mortality, 6-month and 12-month mortality, 12-month GOSE score, and 6-month and 12-month measures of disability, well-being, quality of life, and life satisfaction.Main resultsOf the 450 eligible participants, 57 (13%) received early beta blockers (BB+ group). The BB+ group was on average older, more likely to be on a preinjury beta blocker, and more likely to have a history of hypertension. In the BB+ group, 34 participants (60%) received metoprolol only, 19 participants (33%) received propranolol only, 3 participants (5%) received both, and 1 participant (2%) received atenolol only. In multivariable regression, there was no difference in the odds of a higher GOSE score at 6 months between the BB+ group and BB- group (odds ratio = 0.86; 95% CI, 0.48-1.53). There was no association between BB exposure and secondary outcomes.ConclusionsAbout one-sixth of subjects in our study received early beta blockers, and within this group, dose, and timing of beta-blocker administration varied substantially. No significant differences in GOSE score at 6 months were demonstrated, although our ability to draw conclusions is limited by overall low total doses administered compared with prior studies. | |
| dc.identifier.issn | 2639-8028 | |
| dc.identifier.issn | 2639-8028 | |
| dc.identifier.uri | ||
| dc.language | eng | |
| dc.publisher | Ovid Technologies (Wolters Kluwer Health) | |
| dc.relation.ispartof | Critical care explorations | |
| dc.relation.isversionof | 10.1097/cce.0000000000000958 | |
| dc.subject | beta blocker | |
| dc.subject | cardioselective | |
| dc.subject | disability | |
| dc.subject | functional | |
| dc.subject | traumatic brain injury | |
| dc.title | Association of Early Beta-Blocker Exposure and Functional Outcomes in Critically Ill Patients With Moderate to Severe Traumatic Brain Injury: A Transforming Clinical Research and Knowledge in Traumatic Brain Injury Study. | |
| dc.type | Journal article | |
| duke.contributor.orcid | Komisarow, Jordan|0000-0003-3919-7931 | |
| duke.contributor.orcid | Ohnuma, Tetsu|0000-0002-2303-6802 | |
| duke.contributor.orcid | Treggiari, Miriam M|0000-0003-4639-3682 | |
| duke.contributor.orcid | Laskowitz, Daniel T|0000-0003-3430-8815 | |
| duke.contributor.orcid | Mathew, Joseph P|0000-0002-3815-4131 | |
| duke.contributor.orcid | Hernandez, Adrian|0000-0003-3387-9616 | |
| duke.contributor.orcid | James, Michael L|0000-0002-8715-5210 | |
| duke.contributor.orcid | Raghunathan, Karthik|0000-0003-2809-5374 | |
| duke.contributor.orcid | Goldstein, Ben|0000-0001-5261-3632 | |
| duke.contributor.orcid | Krishnamoorthy, Vijay|0000-0002-1365-4121|0000-0003-4153-2348 | |
| pubs.begin-page | e0958 | |
| pubs.issue | 9 | |
| pubs.organisational-group | Duke | |
| pubs.organisational-group | School of Medicine | |
| pubs.organisational-group | Basic Science Departments | |
| pubs.organisational-group | Clinical Science Departments | |
| pubs.organisational-group | Institutes and Centers | |
| pubs.organisational-group | Biostatistics & Bioinformatics | |
| pubs.organisational-group | Anesthesiology | |
| pubs.organisational-group | Anesthesiology, Cardiothoracic | |
| pubs.organisational-group | Anesthesiology, Critical Care Medicine | |
| pubs.organisational-group | Anesthesiology, Neuroanesthesia | |
| pubs.organisational-group | Anesthesiology, VA Anesthesiology Service | |
| pubs.organisational-group | Medicine | |
| pubs.organisational-group | Pediatrics | |
| pubs.organisational-group | Surgery | |
| pubs.organisational-group | Medicine, Cardiology | |
| pubs.organisational-group | Trauma, Acute, and Critical Care Surgery | |
| pubs.organisational-group | Duke Clinical Research Institute | |
| pubs.organisational-group | Institutes and Provost's Academic Units | |
| pubs.organisational-group | Neurology | |
| pubs.organisational-group | Neurology, Neurocritical Care | |
| pubs.organisational-group | Initiatives | |
| pubs.organisational-group | Neurosurgery | |
| pubs.organisational-group | Population Health Sciences | |
| pubs.organisational-group | Duke Innovation & Entrepreneurship | |
| pubs.organisational-group | Pediatrics, Children's Health Discovery Institute | |
| pubs.organisational-group | Duke - Margolis Center For Health Policy | |
| pubs.organisational-group | Biostatistics & Bioinformatics, Division of Translational Biomedical | |
| pubs.publication-status | Published | |
| pubs.volume | 5 |
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