دورية أكاديمية
أعرض في EDS

Association of Central Nervous System-Affecting Medications With Occurrence and Short-Term Mortality of Traumatic Brain Injury.

التفاصيل البيبلوغرافية
العنوان: Association of Central Nervous System-Affecting Medications With Occurrence and Short-Term Mortality of Traumatic Brain Injury.
المؤلفون: Cajanus K; Department of Clinical Pharmacology, Turku University Hospital and University of Turku, Turku , Finland., Kytö V; Heart Centre and Center for Population Health Research, Turku University Hospital and University of Turku, Turku , Finland.; Research Services, Turku University Hospital, Turku , Finland., Ruuskanen JO; Neurocenter, Department of Neurology, Turku University Hospital and University of Turku, Turku , Finland., Luoto TM; Department of Neurosurgery, Tampere University Hospital and Tampere University, Tampere , Finland., Rautava P; Clinical Research Center, Turku University Hospital and University of Turku, Turku , Finland., Tornio A; Department of Clinical Pharmacology, Turku University Hospital and University of Turku, Turku , Finland., Posti JP; Neurocenter, Department of Neurosurgery and Turku Brain Injury Center, Turku University Hospital and University of Turku, Turku , Finland.
المصدر: Neurosurgery [Neurosurgery] 2024 Apr 01; Vol. 94 (4), pp. 721-728. Date of Electronic Publication: 2023 Oct 18.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins, Inc Country of Publication: United States NLM ID: 7802914 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1524-4040 (Electronic) Linking ISSN: 0148396X NLM ISO Abbreviation: Neurosurgery Subsets: MEDLINE
أسماء مطبوعة: Publication: 2022- : [Philadelphia] : Lippincott Williams & Wilkins, Inc.
Original Publication: Baltimore, Williams & Wilkins.
مواضيع طبية MeSH: Antidepressive Agents, Second-Generation* , Antipsychotic Agents*/adverse effects , Brain Injuries, Traumatic*/drug therapy, Humans ; Benzodiazepines/adverse effects ; Central Nervous System
مستخلص: Background and Objectives: The use of medications commonly prescribed after traumatic brain injury (TBI) has been little studied before TBI. This study examined the association between the use of medications that affect the central nervous system (CNS) and the occurrence and short-term mortality of TBI.
Methods: Mandatory Finnish registries were used to identify TBI admissions, fatal TBIs, and drug purchases during 2005-2018. Patients with TBI were 1:1 matched to nontrauma control patients to investigate the association between medications and the occurrence of TBI and 30-day mortality after TBI. Number needed to harm (NNH) was calculated for all medications.
Results: The cohort included 59 606 patients with TBI and a similar number of control patients. CNS-affecting drugs were more common in patients with TBI than in controls [odds ratio = 2.07 (2.02-2.13), P < .001)]. Benzodiazepines were the most common type of medications in patients with TBI (17%) and in controls (11%). The lowest NNH for the occurrence of TBI was associated with benzodiazepines (15.4), selective serotonin uptake inhibitors (18.5), and second-generation antipsychotics (25.8). Eight percent of the patients with TBI died within 30 days. The highest hazard ratios (HR) and lowest NNHs associated with short-term mortality were observed with strong opioids [HR = 1.41 (1.26-1.59), NNH = 33.1], second-generation antipsychotics [HR = 1.36 (1.23-1.50), NNH = 37.1], and atypical antidepressants [HR = 1.17 (1.04-1.31), NNH = 77.7].
Conclusion: Thirty-seven percent of patients with TBI used at least 1 CNS-affecting drug. This proportion was significantly higher than in the control population (24%). The highest risk and lowest NNH for short-term mortality were observed with strong opioids, second-generation antipsychotics, and atypical antidepressants. The current risks underscore the importance of weighing the benefits and risks before prescribing CNS-affecting drugs in patients at risk of head injury.
(Copyright © Congress of Neurological Surgeons 2023. All rights reserved.)
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معلومات مُعتمدة: 349758 Terveyden Tutkimuksen Toimikunta; 17379 Terveyden Tutkimuksen Toimikunta; 11129 Competitive State Research Financing of the Expert Responsibility area of Turku University Hospital
المشرفين على المادة: 0 (Antidepressive Agents, Second-Generation)
0 (Antipsychotic Agents)
12794-10-4 (Benzodiazepines)
تواريخ الأحداث: Date Created: 20231018 Date Completed: 20240319 Latest Revision: 20240724
رمز التحديث: 20240725
DOI: 10.1227/neu.0000000000002732
PMID: 37850916
قاعدة البيانات: MEDLINE
الوصف
تدمد:1524-4040
DOI:10.1227/neu.0000000000002732