Abstract
BACKGROUND: Traumatic brain injury (TBI) represents a significant public health challenge due to its complex management. β-blockers may offer neuroprotective benefits, but their impact on TBI outcomes remains unclear. This study aims to evaluate the effect of β-blocker use on clinical outcomes in TBI patients. METHODS: This retrospective cohort study included adult TBI patients, categorized into β-blocker and non-β-blocker groups. Propensity score matching (PSM) was utilized to balance baseline characteristics. Mortality was assessed through the application of multivariable Cox regression models and Kaplan-Meier survival curves. Subgroup analyses examined the consistency of the results. RESULTS: A total of 1,516 patients were included in the study, with 750 receiving β-blocker therapy and 766 not receiving it. After PSM, 473 pairs of patients were matched. The analysis indicated that β-blockers significantly reduce 28-day mortality (HR 0.43, 95% CI: 0.31-0.60, P < 0.001). However, patients receiving β-blocker had considerably longer hospital stays (7.89 days vs. 5.45 days, P < 0.001) and ICU stays (2.94 days vs. 2.33 days, P < 0.001). CONCLUSION: β-blocker therapy is associated with improved short-term outcomes in patients with TBI, particularly in those with mild (GCS 13-15) and severe (GCS 3-8) TBI. However, no significant benefit was observed in patients with moderate TBI (GCS 9-12). This therapy may also prolong hospital and ICU stays.