Evidence map›Paper›PMID 25370543›Full record

ArticleJournal of postgraduate medicine

Pre-injury neuro-psychiatric medication use, alone or in combination with cardiac medications, may affect outcomes in trauma patients.

J R Wisler, A N Springer, K Hateley, X M Mo, D C Evans, C H Cook, A T Gerlach, C V Murphy, D S Eiferman, S M Steinberg and 3 more

Abstract read
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Article in Journal of postgraduate medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–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

7 citing papers in PubMed.

  1. Article
  2. Article
  3. Author's reply: To PMID 25370543.Journal of postgraduate medicine
    Article
  4. Article
  5. Review
  6. Author's reply: To PMID 25370543.Journal of postgraduate medicine
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  7. Use of visual aids in presenting study results.Journal of postgraduate medicine
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors.

J R Wisler
A N Springer
K Hateley
X M Mo
D C Evans
C H Cook
A T Gerlach
C V Murphy
D S Eiferman
S M Steinberg
S D Bergese
T J Papadimos
S P StawickiDepartment of Research & Innovation, St Luke's University Health Network, Bethlehem, Pennsylvania, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRecent review of older (≥45-years-old) patients admitted to our trauma center showed that more than one-third were using neuro-psychiatric medications (NPMs) prior to their injury-related admission. Previously published data suggests that use of NPMs may increase patients' risk and severity of injury. We sought to examine the impact of pre-injury NPM use on older trauma patients' morbidity and mortality. MATERIALS AND

methodsRetrospective record review included medication regimen characteristics and NPM use (antidepressants-AD, antipsychotics-AP, anxiolytics-AA). Hospital morbidity, mortality, and 90-day survival were examined. Comparisons included regimens involving NPMs, further focusing on their interactions with various cardiac medications (beta blocker - BB; angiotensin-converting enzyme inhibitor/angiotensin receptor blocker - ACE/ARB; calcium channel blocker - CCB).

results712 patient records were reviewed (399 males, mean age 63.5 years, median ISS 8). 245 patients were taking at least 1 NPM: AD (158), AP (35), or AA (108) before injury. There was no effect of NPM monotherapy on hospital mortality. Patients taking ≥3 NPMs had significantly lower 90-day survival compared to patients taking ≤2 NPMs (81% for 3 or more NPMs, 95% for no NPMs, and 89% 1-2 NPMs, P < 0.01). Several AD-cardiac medication (CM) combinations were associated with increased mortality compared to monotherapy with either agent (BB-AD 14.7% mortality versus 7.0% for AD monotherapy or 4.8% BB monotherapy, P < 0.05). Combinations of ACE/ARB-AA were associated with increased mortality compared to ACE/ARB monotherapy (11.5% vs 4.9, P = 0.04). Finally, ACE/ARB-AD co-administration had higher mortality than ACE/ARB monotherapy (13.5% vs 4.9%, P = 0.01).

conclusionsLarge proportion of older trauma patients was using pre-injury NPMs. Several regimens involving NPMs and CMs were associated with increased in-hospital mortality. Additionally, use of ≥3 NPMs was associated with lower 90-day survival.

Indexed as

Hospital MortalityPolypharmacyAdrenergic beta-AntagonistsAgedAged, 80 and overAngiotensin-Converting Enzyme InhibitorsDrug Therapy, CombinationFemaleHumansHypertensionInjury Severity ScoreMaleMental DisordersMiddle AgedRetrospective StudiesWounds and InjuriesAdrenergic beta-AntagonistsAngiotensin-Converting Enzyme Inhibitors

Identifiers

PMID25370543

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.