SynthesisNeurocritical care2020
Beta-Blockade in Aneurysmal Subarachnoid Hemorrhage: a Systematic Review and Meta-Analysis.
Synthesis in Neurocritical care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 22 citations in OpenAlex.
- Fentanyl versus placebo with ketamine and rocuronium for patients undergoing rapid sequence intubation in the emergency department: The FAKT study-A randomized clinical trial.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2022Trial
- Beta-blockers in adults with acute traumatic brain injury: a systematic review and meta-analysis of randomized controlled trials.Journal of anesthesia, analgesia and critical care · 2025Review
- On Neurocardiology Updates: an Interdisciplinary Field at the Intersection of Neurology and Cardiology.Current neurology and neuroscience reports · 2025Review
- Exploring hypertension-linked diseases: a comprehensive review of innovative drug combinations with enhanced therapeutic potential.Naunyn-Schmiedeberg's archives of pharmacology · 2025Review
- Identification of Risk Factors Influencing Hemorrhage Volume in Aneurysmal Subarachnoid Hemorrhage: A Multicenter Retrospective Study.Brain and behavior · 2025Article
- Review
- Problematic meta-analyses: Bayesian and frequentist perspectives on combining randomized controlled trials and non-randomized studies.BMC medical research methodology · 2024Article
- Pharmacotherapy in SAH: Clinical Trial Lessons.CNS & neurological disorders drug targets · 2024Review
- Rupture of a previously undiagnosed intracranial aneurysm during endoscopic dacryocystorhinostomy: A case report.Clinical case reports · 2023Article
- Beta-Blockers for Subarachnoid Hemorrhage: When Should We Use Them?Neurocritical care · 2020Article
- Reply to: 'Beta-blockers for subarachnoid hemorrhage: When should we use them?'Neurocritical care · 2020Article
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND/
objectiveSympathetic nervous system activation after aneurysmal subarachnoid hemorrhage (aSAH) is associated with complications and poor outcome. In this systematic review and meta-analysis, we investigate the effect of beta-blockers on outcome after aSAH.
methodsThe review was prospectively registered with PROSPERO (CRD42019111784). We performed a systematic literature search of MEDLINE, EMBASE, the Cochrane Library, published conference proceedings, and abstracts. Eligible studies included both randomized controlled trials and observational studies up to October 2018, reporting the effect of beta-blocker therapy on the following outcomes in aSAH: mortality, vasospasm, delayed cerebral ischemia, infarction or stroke, cardiac dysfunction, and functional outcomes. Studies involving traumatic SAH were excluded. Citations were reviewed, and data extracted independently by two investigators using a standardized proforma.
resultsWe identified 819 records with 16 studies (four were randomized controlled trials) including 6702 patients selected for analysis. Exposure to beta-blockade either before or after aSAH was associated with a significant reduction in unadjusted mortality (RR 0.63, 95% CI 0.42-0.93, p = 0.02). A significant reduction in unadjusted mortality was also seen in prospective trials of post-event beta-blockade (RR 0.51, 95% CI 0.28-0.93, p = 0.03). Statistically significant differences were not seen for other outcomes investigated.
conclusionsIn adult patients with aSAH, beta-blocker therapy is associated with a mortality benefit. Studies are generally of a low quality with considerable clinical heterogeneity. Prospective large interventional trials with patient centered outcomes are required to validate this finding.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.