Evidence map›Paper›PMID 25364018›Full record

ArticleThe Canadian journal of hospital pharmacy2014

Incidence of and factors associated with manipulation of nimodipine dosage in patients with aneurysmal subarachnoid hemorrhage.

Meghan MacKenzie, Sean K Gorman, Steve Doucette, Robert Green

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Canadian journal of hospital pharmacy, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
0.6field-weighted citation impact, top 30% of its field
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, 14 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 1 country.

Meghan MacKenzieBSc(Pharm), ACPR, PharmD, is Clinical Coordinator-Critical Care and Emergency Medicine, Pharmacy Department, Capital District Health Authority, and Assistant Professor, College of Pharmacy, Dalhousie University, Halifax, Nova Scotia. This study was undertaken while she was completing her Pharmacy Residency at Capital Health/Dalhousie.
Sean K GormanBSc(Pharm), ACPR, PharmD, is Regional Coordinator - Clinical Quality and Research and Pharmacotherapeutic Specialist - Critical Care with Pharmacy Services, Interior Health Authority, Kelowna, British Columbia. He is also a Clinical Associate Professor in the Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia.
Steve DoucetteMSc, is Senior Biostatistician in the Research Methods Unit, Capital District Health Authority, Halifax, Nova Scotia.
Robert GreenBSc, MD, FRCPC, DABEM, is a Professor in the Department of Anesthesia, Division of Critical Care Medicine, and the Department of Emergency Medicine, Dalhousie University, and is also Medical Director of the Nova Scotia Trauma Program, Halifax, Nova Scotia.
Capital District Health Authority · CADalhousie University · CAUniversity of British Columbia · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAneurysmal subarachnoid hemorrhage is a significant cause of death and disability. Nimodipine 60 mg administered enterally every 4 h improves neurologic outcomes in these patients. However, hypotension is an adverse effect of nimodipine and is believed to prompt clinicians to prescribe an unproven, nonstandard nimodipine dosing regimen.

objectivesThe primary objective was to determine the prescribing incidence of a nonstandard nimodipine dosing regimen (30 mg every 2 h) after initial prescription of the standard dose (60 mg every 4 h). The secondary objective was to determine factors associated with this dosage change.

methodsThis retrospective cohort study evaluated participants receiving nimodipine for aneurysmal subarachnoid hemorrhage at a tertiary care teaching hospital between October 2005 and December 2011. Univariate and multivariate regression analyses were performed to identify factors associated with dosage manipulation.

resultsA total of 166 eligible patients were identified. For all of these patients, nimodipine 60 mg every 4 h was prescribed initially. Subsequently, 81 (49%) of the patients were switched to nimodipine 30 mg every 2 h, whereas 85 (51%) continued on the original dosage (nimodipine 60 mg every 4 h) for the duration of their treatment. Multivariate analysis revealed that occurrence of vasospasm (odds ratio [OR] 5.30, 95% confidence interval [CI] 2.08-13.47; p < 0.001) and exposure to vasopressor therapy (OR 3.29, 95% CI 1.27-8.50; p = 0.014) were associated with increased odds of receiving the nonstandard nimodipine regimen.

conclusionsHalf of patients for whom nimodipine was prescribed for aneurysmal subarachnoid hemorrhage were exposed to an unproven regimen. Vasospasm and exposure to vasopressor therapy were associated with higher odds of receiving the nonstandard regimen. Further research is needed to evaluate whether nimodipine 30 mg every 2 h is efficacious and safe for patients in this population.

Indexed as

dosage regimennimodipinesubarachnoid hemorrhage

Identifiers

PMID25364018
PMCPMC4214578
OpenAlexW2004007210

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.