Pre-injury polypharmacy predicts mortality in isolated severe traumatic brain injury patients.
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.
Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA. Electronic address: joshua.catapano@barrowbrainandspine.com.
Joshua S
JS
Catapano
Department of Surgery, University of Nevada School of Medicine, Las Vegas, NV, USA.
Alistair J
AJ
Chapman
Department of Neurosurgery, University of Nevada School of Medicine, Reno, NV, USA.
Lance P
LP
Horner
Department of Community Health Sciences, University of Nevada, Reno, NV, USA.
Minggen
M
Lu
Department of Surgery, University of Nevada School of Medicine, Las Vegas, NV, USA.
Douglas R
DR
Fraser
Department of Surgery, University of Nevada School of Medicine, Las Vegas, NV, USA.
John J
JJ
Fildes
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000070642:Brain Injuries, Traumatic / Q000401:mortality*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D019338:Polypharmacy; D012189:Retrospective Studies; D012307:Risk Factors; D015599:Trauma Severity Indices
Polypharmacy; Severe head injury; TBI; Trauma; Traumatic brain injury