There is no direct evidence that beta-blockers
improve mortality in burn
attenuate hypermetabolic states in burned children, and perioperative use in elective adult cases has beneficial effects, which suggests that beta-blockers
may also improve burn outcomes
. However, beta-blockers
decrease cardiac output and may decrease oxygen delivery, and theoretically may increase mortality. What is the effect of beta-blockers
time and mortality in burn
This was a retrospective cohort study. We identified three cohorts of adult burn
patients between 1996 and 2001: all who were on beta-blockers
(BB) before their injury
(PMH BB); all who were initiated on BB during their hospitalization for management of hypertension or tachyarrhythmia (HOSP BB); and control, who were never treated with beta-blockers
. For each patient in the PMH BB and HOSP BB groups, two patients were placed in the control cohort by matching age and total body surface area burn
. Premorbid conditions such as diabetes, hypertension, cardiac disease, renal insufficiency, and diuretic and calcium channel blocker use were analyzed. Multivariate regression models were used to identify independent modifiers.
There were 21 PMH BB, 22 HOSP BB, and 86 control patients. All PMH BB patients remained on their BB regimen in the hospital. HOSP BB patients were initiated on beta-blockers
at a mean of 8.8 days postinjury. There were no differences in age (mean, 58 ± 17 years), total body surface area burned (mean, 14 ± 12%), or mechanism of injury
among the cohorts. The mortality rate was 5% for the PMH BB cohort, 27% for the HOSP BB cohort, and 13% for controls. The mean healing
times were 51 ± 29 days for PMH BB patients, 79 ± 54 days for HOSP BB patients, and 60 ± 39 for controls. In multivariate analyses, PMH BB was associated with a significant decrease in fatal outcome and healing
≤ 0.05 compared with control).
have the potential to improve adult burn outcomes
. Postinjury treatment should be studied in a randomized, clinical trial.