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ORIGINAL ARTICLE

The use of beta-blockers before major trauma and posttrauma outcome: A nationwide population-based study


1 Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center; Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
2 Department of Medical Research, Tri-Service General Hospital; School of Public Health, National Defense Medical Center; Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
3 Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 112, Taiwan
4 Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
5 Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 112; Department of Physiology and Biophysics, Graduate Institute of Physiology, National Defense Medical Center, Taipei, Taiwan

Correspondence Address:
Shih-Hung Tsai,
Department of Emergency Medicine, National Defense Medical Center, Tri-Service General Hospital, No. 325, Sector 2, Cheng-Kung Road, Neihu Dist., Taipei City 11490
Taiwan
Wu-Chien Chien,
Department of Medical Research, National Defense Medical Center, Tri-Service General Hospital, No. 325, Sector 2, Cheng-Kung Road, Neihu Dist., Taipei City 11490
Taiwan
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jmedsci.jmedsci_250_21

Background: Beta-blockers are widely used for the treatment of arrhythmia, hypertension, and congestive heart failure. Major trauma causes significant blood loss and subsequent tachycardia and hypotension. Although beta-blockers may induce negative compensatory sympathetic responses to hemorrhagic shock, the effects of beta-blocker use before major trauma on posttrauma outcomes are controversial. Aim: We examined the association between the use of beta-blockers before major trauma and posttrauma outcomes using a nationwide population-based database. Methods: The data for this nationwide population-based retrospective cohort study were obtained from the National Health Insurance Research Database in Taiwan. A total of 2245 beta-blocker users were assigned to the study cohort, and another 8980 patients matched for age, sex, comorbidity, and medication use by inverse probability of treatment weighting formed the comparison cohort. The major outcome assessed was all-cause mortality during a 30-day follow-up period in major trauma patients with or without pretrauma beta-blocker use. Results: Our study included 2245 patients who used beta-blockers before major trauma. Individuals who used beta-blockers did not have a significantly higher cumulative risk of mortality than individuals who did not use beta-blockers (beta-blockers users: 17.19%, nonbeta-blockers users: 16.70%, P = 0.662). Conclusion: Pretrauma beta-blocker users did not have a higher mortality rate after a major trauma even after adjusting for several comorbidities and medications in a nationwide population database.


 

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