A systematic review and meta-analysis on effect of beta-blockers in severe traumatic brain injury

Objectives: Systematically review the medical literature for the impact of beta-blockers on mortality and functional capacity in patients who suffered severe traumatic brain injury. Data Sources: The search included MEDLINE, EMBASE, and Ovid Evidence-Based Medicine, clinical trial registries, and bi...

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Autores:
Florez Perdomo, William A.
Laiseca Torres, Edgar Felipe
Serrato, Sergio a
Janjua, Tariq
Joaquim, Andrei F.
Moscote Salazar, Luis Rafael
Tipo de recurso:
Article of journal
Fecha de publicación:
2021
Institución:
Universidad El Bosque
Repositorio:
Repositorio U. El Bosque
Idioma:
eng
OAI Identifier:
oai:repositorio.unbosque.edu.co:20.500.12495/5884
Acceso en línea:
http://hdl.handle.net/20.500.12495/5884
https://doi.org/10.1080/01616412.2020.1866385
Palabra clave:
Beta-(β)-blockers improve outcomes after acute traumatic brain injury (TBI)
Rights
openAccess
License
Acceso abierto
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dc.title.spa.fl_str_mv A systematic review and meta-analysis on effect of beta-blockers in severe traumatic brain injury
dc.title.translated.spa.fl_str_mv A systematic review and meta-analysis on effect of beta-blockers in severe traumatic brain injury
title A systematic review and meta-analysis on effect of beta-blockers in severe traumatic brain injury
spellingShingle A systematic review and meta-analysis on effect of beta-blockers in severe traumatic brain injury
Beta-(β)-blockers improve outcomes after acute traumatic brain injury (TBI)
title_short A systematic review and meta-analysis on effect of beta-blockers in severe traumatic brain injury
title_full A systematic review and meta-analysis on effect of beta-blockers in severe traumatic brain injury
title_fullStr A systematic review and meta-analysis on effect of beta-blockers in severe traumatic brain injury
title_full_unstemmed A systematic review and meta-analysis on effect of beta-blockers in severe traumatic brain injury
title_sort A systematic review and meta-analysis on effect of beta-blockers in severe traumatic brain injury
dc.creator.fl_str_mv Florez Perdomo, William A.
Laiseca Torres, Edgar Felipe
Serrato, Sergio a
Janjua, Tariq
Joaquim, Andrei F.
Moscote Salazar, Luis Rafael
dc.contributor.author.none.fl_str_mv Florez Perdomo, William A.
Laiseca Torres, Edgar Felipe
Serrato, Sergio a
Janjua, Tariq
Joaquim, Andrei F.
Moscote Salazar, Luis Rafael
dc.subject.keywords.spa.fl_str_mv Beta-(β)-blockers improve outcomes after acute traumatic brain injury (TBI)
topic Beta-(β)-blockers improve outcomes after acute traumatic brain injury (TBI)
description Objectives: Systematically review the medical literature for the impact of beta-blockers on mortality and functional capacity in patients who suffered severe traumatic brain injury. Data Sources: The search included MEDLINE, EMBASE, and Ovid Evidence-Based Medicine, clinical trial registries, and bibliographies. Study Selection: All articles that reported outcome in TBI patients treated with beta-blockers. Data Extraction: Publication year, number of patients, outcome and follow-up. We performed a meta-analysis for each variable for which there were sufficient data to estimate mean differences. Data Synthesis: 12 studies were included, which involved retrospectively and prospectively collected data on 14,057 patients. The treatment with beta-blockers was associated with a reduction in mortality in patients who were treated with beta-blockers compared to the control group (OR 0.40, 95% CI 0.30–0.54p = <0.00001), with acceptable heterogeneity between studies (I2 = 65% p = 0.00008). Beta-blocker therapy decreases the risk of negative neurological and functional outcomes (OR 0.59, 95% CI 0.38–0.92 p = <0.00001), a very high statistical heterogeneity between the included studies (I2 = 80% p = 0.00004), being able to influence the results. An increase in favorable neurological and functional outcomes is shown (OR 1.19, 95% CI 1.07–1.31 p = 0.001) with acceptable heterogeneity (I2 = 52% p = 0.08) Conclusions: The beta-blockers therapy is associated with significantly improves outcome in patients with TBI. Treatment with beta-blockers in patients with TBI is a promising frontier in neurotrauma. Abbreviations:CI: confidence interval; BB: Beta-Blockers; OR = odds ratio; TBI: Traumatic Brain Injury SD: Standard deviation; SNS: Sympathetic nervous system
publishDate 2021
dc.date.accessioned.none.fl_str_mv 2021-05-20T16:22:59Z
dc.date.available.none.fl_str_mv 2021-05-20T16:22:59Z
dc.date.issued.none.fl_str_mv 2021-01-22
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dc.type.local.none.fl_str_mv Artículo de revista
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dc.identifier.doi.none.fl_str_mv https://doi.org/10.1080/01616412.2020.1866385
dc.identifier.instname.spa.fl_str_mv instname:Universidad El Bosque
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url http://hdl.handle.net/20.500.12495/5884
https://doi.org/10.1080/01616412.2020.1866385
dc.language.iso.none.fl_str_mv eng
language eng
dc.relation.ispartofseries.spa.fl_str_mv Neurological Research, 1743-1328, 2021
dc.relation.uri.none.fl_str_mv https://www.tandfonline.com/doi/full/10.1080/01616412.2020.1866385
dc.rights.local.spa.fl_str_mv Acceso abierto
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dc.publisher.spa.fl_str_mv Taylor & Francis Group
dc.publisher.journal.spa.fl_str_mv Neurological Research
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spelling Florez Perdomo, William A.Laiseca Torres, Edgar FelipeSerrato, Sergio aJanjua, TariqJoaquim, Andrei F.Moscote Salazar, Luis Rafael2021-05-20T16:22:59Z2021-05-20T16:22:59Z2021-01-221743-1328http://hdl.handle.net/20.500.12495/5884https://doi.org/10.1080/01616412.2020.1866385instname:Universidad El Bosquereponame:Repositorio Institucional Universidad El Bosquerepourl:https://repositorio.unbosque.edu.coapplication/pdfengTaylor & Francis GroupNeurological ResearchNeurological Research, 1743-1328, 2021https://www.tandfonline.com/doi/full/10.1080/01616412.2020.1866385A systematic review and meta-analysis on effect of beta-blockers in severe traumatic brain injuryA systematic review and meta-analysis on effect of beta-blockers in severe traumatic brain injuryArtículo de revistahttp://purl.org/coar/resource_type/c_6501http://purl.org/coar/resource_type/c_2df8fbb1info:eu-repo/semantics/articlehttp://purl.org/coar/version/c_970fb48d4fbd8a85Beta-(β)-blockers improve outcomes after acute traumatic brain injury (TBI)Objectives: Systematically review the medical literature for the impact of beta-blockers on mortality and functional capacity in patients who suffered severe traumatic brain injury. Data Sources: The search included MEDLINE, EMBASE, and Ovid Evidence-Based Medicine, clinical trial registries, and bibliographies. Study Selection: All articles that reported outcome in TBI patients treated with beta-blockers. Data Extraction: Publication year, number of patients, outcome and follow-up. We performed a meta-analysis for each variable for which there were sufficient data to estimate mean differences. Data Synthesis: 12 studies were included, which involved retrospectively and prospectively collected data on 14,057 patients. The treatment with beta-blockers was associated with a reduction in mortality in patients who were treated with beta-blockers compared to the control group (OR 0.40, 95% CI 0.30–0.54p = <0.00001), with acceptable heterogeneity between studies (I2 = 65% p = 0.00008). Beta-blocker therapy decreases the risk of negative neurological and functional outcomes (OR 0.59, 95% CI 0.38–0.92 p = <0.00001), a very high statistical heterogeneity between the included studies (I2 = 80% p = 0.00004), being able to influence the results. An increase in favorable neurological and functional outcomes is shown (OR 1.19, 95% CI 1.07–1.31 p = 0.001) with acceptable heterogeneity (I2 = 52% p = 0.08) Conclusions: The beta-blockers therapy is associated with significantly improves outcome in patients with TBI. Treatment with beta-blockers in patients with TBI is a promising frontier in neurotrauma. Abbreviations:CI: confidence interval; BB: Beta-Blockers; OR = odds ratio; TBI: Traumatic Brain Injury SD: Standard deviation; SNS: Sympathetic nervous systemAcceso abiertohttp://purl.org/coar/access_right/c_abf2info:eu-repo/semantics/openAccessAcceso abiertoORIGINALFlorez_Perdomo_William_A_2021.pdfFlorez_Perdomo_William_A_2021.pdfapplication/pdf1552314https://repositorio.unbosque.edu.co/bitstreams/9267694d-1014-4635-8853-d37ea4ff2916/downloadfb462b6821d532455a40e7676d6e6f07MD51LICENSElicense.txtlicense.txttext/plain; charset=utf-81748https://repositorio.unbosque.edu.co/bitstreams/4a487ff0-20e0-490f-ae1d-841da87e4101/download8a4605be74aa9ea9d79846c1fba20a33MD52THUMBNAILFlorez_Perdomo_William_A_2021.pdf.jpgFlorez_Perdomo_William_A_2021.pdf.jpgIM Thumbnailimage/jpeg8702https://repositorio.unbosque.edu.co/bitstreams/d7f92cbd-ce6e-476e-856e-87fec4c091a3/downloade9ebaf0d05eca18e7a45ad331a6a9d85MD53TEXTFlorez_Perdomo_William_A_2021.pdf.txtFlorez_Perdomo_William_A_2021.pdf.txtExtracted texttext/plain29846https://repositorio.unbosque.edu.co/bitstreams/67b67133-8a0b-4640-87c3-1c32a737369a/download453d3e44e5fd41c1407e0bff934c7d39MD5420.500.12495/5884oai:repositorio.unbosque.edu.co:20.500.12495/58842024-02-07 06:50:11.25open.accesshttps://repositorio.unbosque.edu.coRepositorio Institucional Universidad El Bosquebibliotecas@biteca.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