Pre-injury polypharmacy predicts mortality in isolated severe traumatic brain injury patients

Am J Surg. 2017 Jun;213(6):1104-1108. doi: 10.1016/j.amjsurg.2016.07.010. Epub 2016 Aug 10.

Abstract

Background: The use of 5 or more medications is defined as polypharmacy (PPM). The clinical impact of PPM on the isolated severe traumatic brain injury (TBI) patient has not been defined.

Methods: A retrospective cohort study was performed at our academic level 1 trauma center examining patients with isolated TBI. Pre-injury medications were reviewed, and inhospital mortality was the primary measured outcome.

Results: There were 698 patients with an isolated TBI over the 5-year study period; 177 (25.4%) patients reported pre-injury PPM. There were 18 (10.2%) deaths in the PPM cohort and 24 (4.6%) deaths in the non-PPM cohort (P < .0001). Stepwise logistic regression analysis revealed a 2.3 times greater risk of mortality in the PPM patients (P = .019).

Conclusions: Pre-injury PPM increases mortality in patients with isolated severe TBI. This knowledge may provide opportunities for intervention in this population.

Keywords: Polypharmacy; Severe head injury; TBI; Trauma; Traumatic brain injury.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Brain Injuries, Traumatic / mortality*
  • Female
  • Hospital Mortality
  • Humans
  • Length of Stay
  • Logistic Models
  • Male
  • Middle Aged
  • Polypharmacy*
  • Retrospective Studies
  • Risk Factors
  • Trauma Severity Indices