The impact of beta-blocker therapy on anemia after traumatic brain injury

Transfusion. 2012 Oct;52(10):2155-60. doi: 10.1111/j.1537-2995.2012.03609.x. Epub 2012 Mar 15.

Abstract

Background: An increase in endogenous catecholamine levels after traumatic brain injury (TBI) is well described. Animal studies suggest that postinjury anemia is exacerbated by a persistent hyperadrenergic state. This study aims to determine if beta-blocker (BB) exposure affects anemia after TBI.

Study design and methods: We reviewed a Level I trauma registry for patients with TBI, examining markers of anemia between patients who received BB with those who did not.

Results: A total of 174 patients were exposed to BB (BB+) and 245 were not exposed (BB-). The mean age in the BB+ group was 50 years (vs. 36 years in BB- group, p < 0.001). The mean injury severity score was 33.6 for the BB+ group (vs. 30.8 for BB- group, p = 0.01). While BB+ patients were more likely to receive a transfusion (60.9% vs. 35.1%, p < 0.001), BB+ patients reached their nadir hemoglobin (Hb) at a later day of hospitalization and their rate of decrease in Hb was significantly slower (both p < 0.001). Choosing Hb cutoffs for anemia of both 7 and 10 g/dL, Kaplan-Meier demonstrated a significant delay in time to anemia.

Conclusion: This study suggests beta-blockade delays anemia after TBI. Elaboration of this effect may demonstrate an additional benefit of beta-blockade after head injury.

MeSH terms

  • Adrenergic beta-Antagonists / administration & dosage
  • Adrenergic beta-Antagonists / therapeutic use*
  • Adult
  • Aged
  • Anemia / etiology
  • Anemia / prevention & control*
  • Blood Transfusion / statistics & numerical data
  • Brain Injuries / blood*
  • Brain Injuries / drug therapy
  • Catecholamines / blood*
  • Drug Evaluation
  • Erythrocyte Transfusion / statistics & numerical data
  • Female
  • Glasgow Coma Scale
  • Hemoglobins / analysis
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Registries
  • Retrospective Studies
  • Trauma Severity Indices
  • Young Adult

Substances

  • Adrenergic beta-Antagonists
  • Catecholamines
  • Hemoglobins