Evidence map›Paper›PMID 34379205›Full record

Observational studyActa neurochirurgica2021

Psychotropic medication use among patients with a traumatic brain injury treated in the intensive care unit: a multi-centre observational study.

Juho Vehviläinen, Markus B Skrifvars, Matti Reinikainen, Stepani Bendel, Ivan Marinkovic, Tero Ala-Kokko, Sanna Hoppu, Ruut Laitio, Jari Siironen, Rahul Raj

Open access · hybridAbstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Acta neurochirurgica, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.8field-weighted citation impact, top 25% 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

4 citing papers in PubMed, 20 citations in OpenAlex.

  1. Observational
  2. Article
  3. Article
  4. Article
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

10 authors at 5 institutions in 1 country.

Juho VehviläinenDepartment of Neurosurgery, Helsinki University Hospital and University of Helsinki, Topeliuksenkatu 5, P.B. 266, 00029 HUS, Helsinki, Finland. juho.vehvilainen@helsinki.fi.ORCID http://orcid.org/0000-0001-7521-8512
Markus B SkrifvarsDepartment of Emergency Care and Services, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Matti ReinikainenDepartment of Intensive Care, Kuopio University Hospital & University of Eastern Finland, Kuopio, Finland.
Stepani BendelDepartment of Intensive Care, Kuopio University Hospital & University of Eastern Finland, Kuopio, Finland.
Ivan MarinkovicDepartment of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Tero Ala-KokkoDepartment of Intensive Care, Oulu University Hospital & University of Oulu, Oulu, Finland.
Sanna HoppuDepartment of Intensive Care and Emergency Medicine Services, Tampere University Hospital & University of Tampere, Tampere, Finland.
Ruut LaitioDepartment of Intensive Care, Turku University Hospital & University of Turku, Turku, Finland.
Jari SiironenDepartment of Neurosurgery, Helsinki University Hospital and University of Helsinki, Topeliuksenkatu 5, P.B. 266, 00029 HUS, Helsinki, Finland.
Rahul RajDepartment of Neurosurgery, Helsinki University Hospital and University of Helsinki, Topeliuksenkatu 5, P.B. 266, 00029 HUS, Helsinki, Finland.
University of Helsinki · FIUniversity of Eastern Finland · FIOulu University Hospital · FITampere University Hospital · FIUniversity of Turku · FI

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPsychiatric sequelae after traumatic brain injury (TBI) are common and may impede recovery. We aimed to assess the occurrence and risk factors of post-injury psychotropic medication use in intensive care unit (ICU)-treated patients with TBI and its association with late mortality.

methodsWe conducted a retrospective multi-centre observational study using the Finnish Intensive Care Consortium database. We included adult TBI patients admitted in four university hospital ICUs during 2003-2013 that were alive at 1 year after injury. Patients were followed-up until end of 2016. We obtained data regarding psychotropic medication use through the national drug reimbursement database. We used multivariable logistic regression models to assess the association between TBI severity, treatment-related variables and the odds of psychotropic medication use and its association with late all-cause mortality (more than 1 year after TBI).

resultsOf 3061 patients, 2305 (75%) were alive at 1 year. Of these, 400 (17%) became new psychotropic medication users. The most common medication types were antidepressants (61%), antipsychotics (35%) and anxiolytics (26%). A higher Glasgow Coma Scale (GCS) score was associated with lower odds (OR 0.93, 95% CI 0.90-0.96) and a diffuse injury with midline shift was associated with higher odds (OR 3.4, 95% CI 1.3-9.0) of new psychotropic medication use. After adjusting for injury severity, new psychotropic medication use was associated with increased odds of late mortality (OR 1.19, 95% CI 1.19-2.17, median follow-up time 6.4 years).

conclusionsPsychotropic medication use is common in TBI survivors. Higher TBI severity is associated with increased odds of psychotropic medication use. New use of psychotropic medications after TBI was associated with increased odds of late mortality. Our results highlight the need for early identification of potential psychiatric sequelae and psychiatric evaluation in TBI survivors.

Indexed as

Brain Injuries, TraumaticAdultGlasgow Coma ScaleHumansIntensive Care UnitsLogistic ModelsRetrospective StudiesIntensive carePsychiatric sequelaePsychotropic medicationTraumatic brain injury

Identifiers

PMID34379205
PMCPMC8437905
OpenAlexW3191995053

What OpenQuestion holds

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LicenceCC BY
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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.