Evidence map›Paper›PMID 34775086›Full record

ArticleWorld neurosurgery2022

Safety of Modified Nimodipine Dosing in Aneurysmal Subarachnoid Hemorrhage.

Leana Mahmoud, Andrew R Zullo, Caitlyn Blake, Xing Dai, Bradford B Thompson, Linda C Wendell, Karen L Furie, Michael E Reznik, Ali Mahta

Abstract read
In one paragraph

Article in World neurosurgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing 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

5 citing papers in PubMed.

  1. Observational
  2. Article
  3. Article
  4. Review
  5. 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

9 authors.

Leana MahmoudDepartment of Pharmacy, Rhode Island Hospital, Providence, Rhode Island, USA.
Andrew R ZulloDepartment of Pharmacy, Rhode Island Hospital, Providence, Rhode Island, USA; Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island, USA.
Caitlyn BlakeDepartment of Pharmacy, Rhode Island Hospital, Providence, Rhode Island, USA; University of Rhode Island College of Pharmacy, Kingston, Rhode Island, USA.
Xing DaiDepartment of Neurology, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
Bradford B ThompsonDepartment of Neurology, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA; Department of Neurosurgery, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
Linda C WendellDepartment of Neurology, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA; Department of Neurosurgery, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA; Section of Medical Education, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
Karen L FurieDepartment of Neurology, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
Michael E ReznikDepartment of Neurology, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA; Department of Neurosurgery, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
Ali MahtaDepartment of Neurology, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA; Department of Neurosurgery, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA. Electronic address: ali_mahta@brown.edu.

Funding

Medications and the Risk of Motor Vehicle Crashes in Older AdultsR01AG065722 · NIA · BROWN UNIVERSITY · PI ZULLO, ANDREW REIS · 2020 to 2023
$2.1M
Opioid use in post-acute hip fracture care: prescribing patterns, effectiveness, and safetyR21AG061632 · NIA · BROWN UNIVERSITY · PI BEAUDOIN, FRANCESCA, ZULLO, ANDREW REIS · 2019 to 2020
$462k
NIA NIH HHS R01 AG065722NIA NIH HHS R21 AG061632
6 · The paper itself

Abstract

backgroundNimodipine improves outcomes in patients with aneurysmal subarachnoid hemorrhage (aSAH). However, the impact of alternative dosing strategies on outcome remains unclear.

methodsWe performed a retrospective cohort study of consecutive patients admitted with aSAH to an academic referral center from 2016 to 2019. Patients with a confirmed aneurysm cause who received nimodipine were included; patients who died or had withdrawal of life-sustaining treatment within 24 hours of admission were excluded. Univariable and multivariable modified Poisson regression models were used to identify predictors of using modified nimodipine dosing (30 mg every 2 hours) versus standard dosing (60 mg every 4 hours). Inverse probability weighted and modified Poisson regression models were used to estimate adjusted risk ratios (RRs) for outcome measures, with poor outcome defined as modified Rankin Scale score 4-6 at 3 months.

resultsWe identified 175 patients with aSAH who met eligibility criteria (mean [SD] age = 57 [13.2] years, 62% female, 73% White); 49% (n = 86) received modified nimodipine dosing. A modified dose was used more frequently in women (RR 2.08, 95% confidence interval [CI] 1.11-3.89, P = 0.02), patients with vasospasm (RR 3.47, 95% CI 1.84-6.51, P < 0.001), and patients who required vasopressors (RR 1.73, 95% CI 1.3-2.32, P < 0.001). Modified dosing was not associated with poor functional outcome (inverse probability weighted RR 1.1, 95% CI 0.8-1.4, P = 0.65).

conclusionsModified dosing of nimodipine is well tolerated and may not be associated with worse functional outcome. Prospective studies are needed to better assess the relationship between nimodipine dosing and outcomes in patients with aSAH.

Indexed as

NimodipineSubarachnoid HemorrhageFemaleHumansMaleMiddle AgedOutcome Assessment, Health CareProspective StudiesRetrospective StudiesTreatment OutcomeNimodipineAneurysmDoseNimodipineOutcomeSubarachnoid hemorrhage

Identifiers

PMID34775086
PMCPMC9091053

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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.