XXXX improves survival in severe @entity131 independent of heart rate control.

@entity1 @entity131 @entity772 @entity1406 @entity130
BACKGROUND: Multiple prior studies have suggested an association between survival and beta-blocker administration in @entity1 with severe @entity131 ( @entity131 ). However, it is unknown whether this benefit of beta-blockers is dependent on heart rate control. The aim of this study was to assess whether rate control affects survival in @entity1 receiving @entity1406 with severe @entity131 . Our hypothesis was that improved survival from beta-blockade would be associated with a reduction in heart rate. METHODS: We performed a 7-y retrospective analysis of all blunt @entity131 @entity1 at a level-1 @entity130 center. @entity1 aged >16  y with head abbreviated @entity130 or 5, admitted to the intensive care unit (ICU) from the operating room or emergency room (ER), were included. @entity1 were stratified into two groups: @entity1406 and no beta-blockers. Using propensity score matching, we matched the @entity1 in two groups in a 1:1 ratio controlling for age, gender, race, admission vital signs, @entity772 scale, injury severity score, mean heart rate monitored during ICU admission, and standard deviation of heart rate during the ICU admission. Our primary outcome measure was mortality. RESULTS: A total of 914 @entity1 met our inclusion criteria, of whom 189 received beta-blockers. A propensity-matched cohort of 356 @entity1 (178: @entity1406 and 178: no beta-blockers) was created. @entity1 receiving @entity1406 had higher survival than those @entity1 who did not receive beta-blockers (78% versus 68%; P  =  0.04); however, there was no difference in the mean heart rate (89.9      13.9 versus 89.9      15; P  =  0.99). Nor was there a difference in the mean of standard deviation of the heart rates (14.7      6.3 versus 14.4      6.5; P  =  0.65) between the two groups. In Kaplan-Meier survival analysis, @entity1 who received @entity1406 had a survival advantage (P  =  0.011) compared with @entity1 who did not receive any beta-blockers. CONCLUSIONS: Our study shows an association with improved survival in @entity1 with severe @entity131 receiving @entity1406 , and this effect appears to be independent of any reduction in heart rate. We suggest that beta-blockers should be administered to all severe @entity131 @entity1 irregardless of any perceived beta-blockade effect on heart rate.
