Beta-blocker exposure in the absence of significant head injuries is associated with reduced mortality in critically ill patients

Am J Surg. 2012 Nov;204(5):697-703. doi: 10.1016/j.amjsurg.2012.02.007. Epub 2012 May 11.


Background: The effect of β-blockade in trauma patients without significant head injuries is unknown. The purpose of this investigation was to determine the impact of β-blocker exposure on mortality in critically injured trauma patients who did not sustain significant head injuries.

Methods: Critically ill trauma patients (Injury Severity Score ≥ 25) admitted to the surgical intensive care unit from January 2000 to December 2008 without severe traumatic brain injuries (head Abbreviated Injury Score ≥ 3) were included in this retrospective review. Patients who received β-blockers within 30 days of intensive care unit admission were compared with those who did not. The primary outcome measure evaluated was in-hospital mortality.

Results: During the 9-year study period, 663 critically injured patients (Injury Severity Score ≥ 25) were admitted to the intensive care unit. Of these, 98 patients (14.8%) received β-blockers. Patients exposed to β-blockers had significantly lower in-hospital mortality (11.2% vs 19.3%, P = .006). Stepwise logistic regression identified β-blocker use as an independent protective factor for mortality (adjusted odds ratio, .37; P = .007) in critically injured patients.

Conclusions: Beta-blocker exposure was associated with reduced mortality in critically injured patients without head injuries. Prospective validation of this finding is warranted.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adrenergic beta-Antagonists / therapeutic use*
  • Adult
  • Brain Injuries
  • Critical Illness
  • Female
  • Hospital Mortality*
  • Humans
  • Length of Stay / statistics & numerical data
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Retrospective Studies
  • Treatment Outcome
  • Wounds and Injuries / complications
  • Wounds and Injuries / drug therapy*
  • Wounds and Injuries / mortality
  • Young Adult


  • Adrenergic beta-Antagonists