Evidence map›Paper›PMID 41230439›Full record

ArticleTrauma surgery & acute care open2025

Trends in the use of opioid and non-opioid analgesics after TBI with and without polytrauma.

Andrew J Medvecz, Amelia W Maiga, Stacie Dusetzina, Oscar D Guillamondegui, Andrew D Wiese

Abstract read
In one paragraph

Article in Trauma surgery & acute care open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

5 authors.

Andrew J MedveczDepartment of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.ORCID https://orcid.org/0000-0002-1918-1329
Amelia W MaigaDepartment of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.ORCID https://orcid.org/0000-0001-6488-7024
Stacie DusetzinaDepartment of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Oscar D GuillamondeguiDepartment of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Andrew D WieseDepartment of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee, USA.ORCID https://orcid.org/0000-0002-0699-4224

Funding

Improving Prognostication for Traumatic Brain InjuryK23GM150110 · NIGMS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Amelia Maiga · 2023 to 2026
$695k
Benzodiazepine restrictions and the prevention of overdoses and other harmsK01DA051683 · NIDA · VANDERBILT UNIVERSITY MEDICAL CENTER · PI WIESE, ANDREW DAVID · 2021 to 2024
$688k
NIDA NIH HHS K01 DA051683NIGMS NIH HHS K23 GM150110
6 · The paper itself

Abstract

Objective: To analyze whether outpatient opioid and non-opioid analgesic prescribing after traumatic brain injury (TBI) admission has varied over time among commercially insured patients in the USA. Setting: 2016-2022 Merative MarketScan commercial claims. Participants: Commercially insured, opioid-naïve adults aged 18-64 hospitalized for TBI and/or long bone fracture (LBF). Design: Retrospective observational study. Main measures: We identified patients filling an opioid, benzodiazepine, muscle relaxant, gabapentinoid or non-steroidal anti-inflammatory drug within 30 days of discharge by injury type (TBI, LBF, both). We calculated the difference in prescription prevalence from 2016 to 2022 among patients with TBI compared with the difference among patients with LBF to estimate the change in prescribing practices over time and then used modified Poisson regression to adjust for confounders. Results: We identified 15,928 patients with TBI only (39.4%), 22,912 patients with LBF (56.6%) and 1,615 patients with both TBI and LBF (4.0%). The proportion of patients filling an opioid was 45.4% after TBI, 75.4% after LBF only and 72.3% after both TBI/LBF. Among all patients, opioid fulfillments were lower in 2022 compared with 2016 (54.6% vs 69.9%; adjusted relative risk (aRR) 0.79 (95% CI 0.77 to 0.82)). Patients with all injury types observed a decrease in opioid prescribing (TBI/LBF: -19.0% (95% CI -27.5% to -10.6%); TBI only: -17.2% (95% CI -20.2% to -14.2%); LBF only: -13.7% (95% CI -15.8% to -11.5%)). Gabapentin use increased from 2016 to 2022 (6.8% vs 19.3%; aRR 2.80 (95% CI 2.52 to 3.11)) whereas muscle relaxant use did not change (14.5% vs 13.5%; aRR 0.93 (95% CI 0.85 to 1.02)). Conclusion: Opioids remain a significant component of postdischarge pain management for hospitalized patients with TBI, with and without LBF, although the prevalence of opioid prescription has declined. Level of evidence: Level III.

Indexed as

Brain Injuries, TraumaticOpioid-Related Disorderspain management

Identifiers

PMID41230439
PMCPMC12603714

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.