The Effect of b-blockade on Survival After Isolated Severe XXXX .

@entity1 @entity131 @entity130 @entity1504
BACKGROUND: Several North American studies have observed survival benefit in @entity1 exposed to b-blockers following @entity131 ( @entity131 ). The purpose of this study was to evaluate the effect of b-blockade on mortality in a Swedish cohort of isolated severe @entity131 @entity1 . METHODS: The @entity130 registry of an urban academic @entity130 center was queried to identify @entity1 with an isolated severe @entity131 between 1/2007 and 12/2011. Isolated severe @entity131 was defined as an @entity1504 with an Abbreviated Injury Scale (AIS) >= 3 excluding extra-cranial injuries AIS >= 3. Multivariable logistic regression analysis was used to determine the effect of b-blocker exposure on mortality. Also, a subgroup analysis was performed to investigate the risk of mortality in @entity1 on pre-admission b-blocker versus not and the effect of specific type of b-blocker on the overall outcome. RESULTS: Overall, 874 @entity1 met the study criteria. Of these, 33  % (n  =  287) were exposed to b-blockers during their hospital admission. The exposed @entity1 were older (62      16  years vs. 49      21  years, p  <  0.001), and more severely injured based on their admission GCS, ISS, and head AIS scores (GCS  <=8: 32  % vs. 28  %, p  =  0.007; ISS >= 16: 71  % vs. 59  %, p  =  0.001; head AIS >= 4: 60  % vs. 45  %, p  <  0.001). The crude mortality was higher in @entity1 who did not receive b-blockers (17  % vs. 11  %, p  =  0.007) during their admission. After adjustment for significant confounders, the @entity1 not exposed to b-blockers had a 5-fold increased risk of in-hospital mortality (AOR 5.0, CI 95  % 2.7-8.5, p  =  0.001). No difference in survival was noted in regards to the type of b-blocker used. Subgroup analysis revealed a higher risk of mortality in @entity1 naive to b-blockers compared to those on pre-admission b-blocker therapy (AOR 3.0 CI 95  % 1.2-7.1, p  =  0.015). CONCLUSIONS: b-blocker exposure after isolated severe @entity131 is associated with significantly improved survival. We also noted decreased mortality in @entity1 on pre-admission b-blocker therapy compared to @entity1 naive to such treatment. Further prospective studies are warranted.
