Outcomes associated with transdermal nicotine replacement therapy in a neurosurgery intensive care unit.
OBJECTIVE
The outcomes associated with transdermal nicotine replacement therapy (NRT) in a neurosurgery intensive care unit (ICU) were studied.


METHODS
Data from pharmacy records, neurosurgery ICU admission logs, and computerized patient charts at the University of Illinois Medical Center at Chicago from January 2001 through August 2008 were reviewed for patients older than 18 years who were admitted to the neurosurgery ICU for neurologic insults. Patients were categorized into three groups: smokers who received transdermal NRT (n = 114), smokers who did not receive transdermal NRT (n = 113), and nonsmokers (n = 113). The primary outcome of this study was unfavorable disposition at discharge from the hospital. Secondary outcomes measured included overall mortality; lengths of hospital and neurosurgery ICU stays; and rates of subarachnoid hemorrhage (SAH) rebleeding, angiographic vasospasm, intracerebral hemorrhage rebleeding, and ischemic stroke.


RESULTS
Overall, there was no difference in unfavorable discharge disposition among the three groups (p = 0.17). However, the group who received NRT had higher admission rates of SAH, smoked more cigarettes for a longer period of time, and had longer stays in the neurosurgery ICU and hospital compared with the other groups. All patients who received NRT had prolonged hospital (p = 0.014) and neurosurgery ICU (p = 0.006) stays compared with those who did not receive NRT. There were no differences in other secondary outcomes among the groups.


CONCLUSIONS
There was no significant difference in unfavorable discharge disposition among neurosurgery ICU patients who were smokers treated with NRT, smokers not treated with NRT, and nonsmokers not treated with NRT.
Panos
Nicholas G
NG
Department of Pharmacy Services, Loyola University Medical Center, 2160 South First Avenue, Maywood, IL 60153, USA. npanos@lumc.edu
Tesoro
Eljim P
EP
Kim
Keri S
KS
Mucksavage
Jeffrey J
JJ
D002641:Chicago; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D020300:Intracranial Hemorrhages / Q000628:therapy; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D009538:Nicotine / Q000008:administration & dosage* / Q000009:adverse effects; D018722:Nicotinic Agonists / Q000008:administration & dosage / Q000009:adverse effects; D012189:Retrospective Studies; D012907:Smoking / Q000188:drug therapy*; D057968:Transdermal Patch; D020196:Trauma, Nervous System / Q000628:therapy; D016896:Treatment Outcome
D018722:Nicotinic Agonists; D009538:Nicotine