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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1016-1020 |
| Number of pages | 5 |
| Journal | The Journal of trauma |
| Volume | 65 |
| Issue number | 5 |
| State | Published - Nov 2008 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Medicine(all)
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Preinjury beta blockers are associated with increased mortality in geriatric trauma patients. / Neideen, Todd; Lam, Michelle; Brasel, Karen J.
In: The Journal of trauma, Vol. 65, No. 5, 11.2008, p. 1016-1020.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Preinjury beta blockers are associated with increased mortality in geriatric trauma patients.
AU - Neideen, Todd
AU - Lam, Michelle
AU - Brasel, Karen J.
PY - 2008/11
Y1 - 2008/11
N2 - 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.
AB - 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.
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M3 - Article
C2 - 19001968
VL - 65
SP - 1016
EP - 1020
JO - Journal of Trauma and Acute Care Surgery
JF - Journal of Trauma and Acute Care Surgery
SN - 2163-0755
IS - 5
ER -