ArticleCritical care medicine2025
Early Vasopressor Utilization in Critically Ill Patients With Acute Traumatic Spinal Cord Injury: A Retrospective Cohort Study.
Article in Critical care medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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Who cites it
2 citing papers in PubMed.
- Mean Arterial Pressure Augmentation for Acute Traumatic Spinal Cord Injury: A Systematic Review and Meta-Analysis of Neurological Recovery and Mortality.Global spine journal · 2026Review
- Autonomic dysfunction and hemodynamic management after acute spinal cord injury: blood pressure targets, perfusion strategies, and emerging therapies.Frontiers in neurology · 2025Review
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
objectivesEvidence regarding vasopressor support for acute spinal cord injury (SCI) is lacking. We report early vasopressor use and hospital outcomes in patients with SCI.
designPropensity-score standardized mortality ratio-weighted retrospective cohort study.
settingU.S. hospitals participating in the Premier Healthcare Database, 2016-2020. PATIENTS: Adults 18 years old or older with acute traumatic SCI at T8 level or above who received vasopressors within 48 hours of hospitalization.
interventionsNone. MEASUREMENTS AND MAIN
resultsOf 3636 patients included (mean [ sd ] age, 56 [19]; 2757 [75%] males), 2055 (57%) received phenylephrine, 548 (15%) received norepinephrine, 110 (3%) received other single vasopressor, and 923 (25%) received multiple vasopressors. Baseline cervical SCIs, higher Injury Severity Scores, neurogenic shock, and mechanical ventilation were more likely with norepinephrine administration. The primary outcome was death/hospice/skilled nursing facility vs. home/inpatient care facility/rehabilitation facility. Compared with the phenylephrine group, the norepinephrine group was more likely to have a discharge disposition of death/hospice/or skilled nursing facility (odds ratio [OR], 1.50; 95% CI, 1.14-1.99), and adverse events, including urinary tract infections (OR, 1.66; 95% CI, 1.17-2.35), cardiac arrest (OR, 2.70; 95% CI, 1.74-4.19), acute kidney injury (OR, 1.91; 95% CI, 1.32-2.77), tracheostomy (OR, 1.39; 95% CI, 1.04-1.86), death (OR, 2.04; 95% CI, 1.42-2.93), and longer hospital length of stay (estimate, 3.68 d; 95% CI, 1.63-5.74 d). We observed no differences in pneumonia, thromboembolic events, or cerebrovascular accidents.
conclusionsPhenylephrine and norepinephrine were the most used vasopressors in SCI patients, with norepinephrine more frequently selected in patients with higher injury severity. While indication bias and residual confounding may explain our findings, these data raise the question whether phenylephrine and norepinephrine have different efficacy and safety profiles. Future research should focus on comparative trials of these two commonly prescribed agents.
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