Evidence map›Paper›PMID 24805007›Full record

ArticleNeurocritical care2014

Potentially inappropriate medication use is associated with clinical outcomes in critically ill elderly patients with neurological injury.

Catherine K Floroff, Patricia W Slattum, Spencer E Harpe, Perry Taylor, Gretchen M Brophy

Abstract read
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In one paragraph

Article in Neurocritical care, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  3. Observational
  4. Article
  5. Article
  6. Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

Catherine K FloroffSchool of Pharmacy, Virginia Commonwealth University, 410 N. 12th Street, Richmond, VA, 23298-0533, USA, kileyc@vcu.edu.
Patricia W Slattum
Spencer E Harpe
Perry Taylor
Gretchen M Brophy

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLimited data suggest that potentially inappropriate medications (PIMs) impact outcomes in critically ill elderly patients. No data are available on the association between PIM use as well as drug burden index (DBI), which is a measure of PIM use, and clinical outcomes in neurocritical care elderly patients. This study evaluates whether PIM use and a higher DBI are associated with poor clinical outcomes in neurocritical care elderly patients.

methodsPIMs were retrospectively identified in critically ill elderly patients admitted to the neuroscience intensive care unit (NSICU) from March to July 2011. DBI was calculated based on PIM doses. Relationships with clinical outcomes were evaluated.

resultsPIMs were prescribed to a majority (81.3 %) of the 112 patients. Opioids were most commonly associated with a decrease in Richmond Agitation Sedation Scale (RASS) scores (56 % of PIM doses). Time to recovery was significantly longer in patients with a higher PIM burden (≤2 PIMs: 8 h, >2 PIMs: 29 h; p = 0.02). There was a significantly longer NSICU and hospital length of stay (9 vs 2; 15 vs 5 days; p < 0.0001) as well as a lower Glasgow Coma Scale score upon discharge (14 vs 15, p = 0.02) in patients with a higher DBI after 72 h of hospitalization. There was no difference in mortality.

conclusionsPIM use and higher DBI scores were associated with poor clinical outcomes and longer lengths of stay. Further studies are needed to determine the impact of PIMs and DBI on mortality in neurocritical care elderly patients.

Indexed as

Brain InjuriesCerebral HemorrhageCritical IllnessStrokeAgedAged, 80 and overAnalgesics, OpioidAntidepressive AgentsAntipsychotic AgentsBenzodiazepinesCholinergic AntagonistsCohort StudiesFemaleGlasgow Coma ScaleHistamine H2 AntagonistsHospital MortalityAnalgesics, OpioidAntidepressive AgentsAntipsychotic AgentsBenzodiazepinesCholinergic AntagonistsHistamine H2 AntagonistsNeuromuscular Blocking Agents

Identifiers

PMID24805007

What OpenQuestion holds

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Registered trials

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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.