Faculty Collaboration Database

Preinjury beta blockers are associated with increased mortality in geriatric trauma patients. J Trauma 2008 Nov;65(5):1016-20

Date

11/13/2008

Pubmed ID

19001968

DOI

10.1097/TA.0b013e3181897eac

Scopus ID

2-s2.0-67650614681 (requires institutional sign-in at Scopus site)   63 Citations

Abstract

INTRODUCTION: Beta-blockade decreases mortality and morbidity in selected older patient populations undergoing noncardiac general surgery. We hypothesized that preinjury beta blockade would increase mortality in geriatric trauma patients, given beta-blockers inhibit patient's physiologic responses to hypovolemic shock.

METHODS: Patients older than 65 years admitted to a level I trauma center were identified by the trauma registry. Medical records were reviewed for demographic and injury information. Preinjury beta blockade was determined by review of nurse and pharmacy admission histories. Logistic regression was used to determine whether there was any correlation between mortality and the use of preinjury beta blockers. Separate models were developed based on the presence or the absence of head injury.

RESULTS: Of the 1,598 patients older than 65 years admitted between 1996 and 2006, 1,479 met inclusion criteria. Primary reason for exclusion was lack of documentation. Two hundred seventy-three patients were taking beta blockers before their trauma, and 14.7% died before discharge. Mortality in patients not taking beta blockers was 13.4%. Mortality in patients with head injury was 25.9%, significantly associated with warfarin use (OR 2.5, 95% CI 1.3-4.8). In patients without head injury, preinjury beta blockade had a significant association with mortality (OR 2.1, 95% CI 1.1-4.3).

CONCLUSIONS: Many factors associated with mortality in elderly trauma patients are similar to the younger patient population. Unique to this population are increased comorbidities and use of prescription medications. Beta blockers, one of these common medications, are associated with increased mortality in the elderly.

Author List

Neideen T, Lam M, Brasel KJ

Author

Todd A. Neideen MD Associate Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adrenergic beta-Antagonists
Aged
Aged, 80 and over
Comorbidity
Female
Humans
Male
Registries
Wounds and Injuries