Evidence map›Paper›PMID 42723549›Full record

ArticlePharmacotherapy2026

Safety of Nonsteroidal Anti-Inflammatory Drug Use in Traumatic Brain Injury.

Jennifer Beavers, Mary Katherine Cella Shultz, Leanne Atchison, Cara Lwin, Dandan Liu, Silky Chotai, Andrew J Medvecz, Robel Beyene, Michael C Smith, Bradley M Dennis and 1 more

Abstract read
In one paragraph

Article in Pharmacotherapy, 2026. 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

11 authors.

Jennifer BeaversDepartment of Pharmaceutical Services, Vanderbilt University Medical Center, Nashville, Tennessee, USA.ORCID https://orcid.org/0000-0002-4042-9501
Mary Katherine Cella ShultzDepartment of Pharmaceutical Services, Vanderbilt University Medical Center, Nashville, Tennessee, USA.ORCID https://orcid.org/0000-0002-0405-7878
Leanne AtchisonMedical Affairs, Cytokinetics, San Francisco, California, USA.
Cara LwinDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.ORCID https://orcid.org/0000-0001-9258-0302
Dandan LiuDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.ORCID https://orcid.org/0000-0002-7176-8346
Silky ChotaiDepartment of Neurological Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA.ORCID https://orcid.org/0000-0001-5981-3231
Andrew J MedveczDivision of Acute Care Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.ORCID https://orcid.org/0000-0002-1918-1329
Robel BeyeneDivision of Acute Care Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.ORCID https://orcid.org/0000-0001-7886-6398
Michael C SmithDivision of Acute Care Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.ORCID https://orcid.org/0000-0002-1136-0250
Bradley M DennisDivision of Acute Care Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.ORCID https://orcid.org/0000-0002-2419-2102
Susan HamblinDepartment of Pharmacy Practice, Lipscomb University College of Pharmacy, Nashville, Tennessee, USA.ORCID https://orcid.org/0009-0008-5400-9752

Funding

Vanderbilt Institute for Clinical and Translational Research (VICTR) -Identifying correlates of functional immunity in SARS-CoV-2 convalescent plasmaUL1TR002243 · NCATS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Paul A. Harris, Wesley H Self · 2017 to 2026
$130.7M
NCATS/NIH UL1TR002243NCATS NIH HHS UL1 TR002243
6 · The paper itself

Abstract

backgroundUse of nonsteroidal anti-inflammatory drugs (NSAIDs) after a traumatic brain injury (TBI) is controversial due to potential worsening of an intracranial hemorrhage (ICH). This study evaluated if NSAID use within 14 days of TBI was associated with a clinically significant progression of intracranial bleed (PIB).

methodsA retrospective, propensity score-weighted study was conducted in adult patients with a TBI admitted to an American College of Surgeons Certified Level I Trauma Center. The NSAID group included patients who received at least one dose of an NSAID within 14 days of injury while admitted. The control group included patients who did not receive NSAIDs. The primary end point was incidence of a clinically significant PIB (decrease in the Glasgow Coma Score (GCS) > 2 and an increased or new ICH). Secondary outcomes included need for additional neurosurgical intervention and PIB on imaging regardless of GCS change.

results978 patients were included: 284 in the NSAID group and 694 in the control group. Most patients had an Abbreviated Injury Score head > 2 (88%) and a subdural hematoma (57%). Fifty-two percent of patients had a mixed bleed. A clinically significant PIB occurred in 0.35% in the NSAID group and 1.2% in the control group (Hazards Ratio 0.1, 95% Confidence Interval 0.01-0.82, p = 0.032). There was no difference in additional neurosurgical operations or PIB regardless of GCS change. In the NSAID group, there was no significant difference in time from admission to NSAID administration between patients who experienced a PIB and those who did not have a PIB (1.9 days vs. 4.7 days, respectively, p = 0.06).

conclusionIn this single-center, retrospective, propensity score-weighted study, NSAIDs were not associated with an increased risk of clinically significant PIB in patients with acute TBI when administered within 14 days of injury. NSAIDs appear safe in the acute phase post-TBI. Prospective studies are needed to validate our results.

Indexed as

Anti-Inflammatory Agents, Non-SteroidalBrain Injuries, TraumaticIntracranial HemorrhagesAdultAgedDisease ProgressionFemaleGlasgow Coma ScaleHumansMaleMiddle AgedPropensity ScoreRetrospective StudiesAnti-Inflammatory Agents, Non-Steroidalintracranial hemorrhagenonsteroidal anti‐inflammatory drugtraumatraumatic brain injury

Identifiers

PMID42723549
PMCPMC13563198

What OpenQuestion holds

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Registered trials

None linked

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.