Psychotropic medication use among patients with a traumatic brain injury treated in the intensive care unit: a multi-centre observational study
Tóm tắt
Psychiatric sequelae after traumatic brain injury (TBI) are common and may impede recovery. We aimed to assess the occurrence and risk factors of post-injury psychotropic medication use in intensive care unit (ICU)-treated patients with TBI and its association with late mortality. We conducted a retrospective multi-centre observational study using the Finnish Intensive Care Consortium database. We included adult TBI patients admitted in four university hospital ICUs during 2003–2013 that were alive at 1 year after injury. Patients were followed-up until end of 2016. We obtained data regarding psychotropic medication use through the national drug reimbursement database. We used multivariable logistic regression models to assess the association between TBI severity, treatment-related variables and the odds of psychotropic medication use and its association with late all-cause mortality (more than 1 year after TBI). Of 3061 patients, 2305 (75%) were alive at 1 year. Of these, 400 (17%) became new psychotropic medication users. The most common medication types were antidepressants (61%), antipsychotics (35%) and anxiolytics (26%). A higher Glasgow Coma Scale (GCS) score was associated with lower odds (OR 0.93, 95% CI 0.90–0.96) and a diffuse injury with midline shift was associated with higher odds (OR 3.4, 95% CI 1.3–9.0) of new psychotropic medication use. After adjusting for injury severity, new psychotropic medication use was associated with increased odds of late mortality (OR 1.19, 95% CI 1.19–2.17, median follow-up time 6.4 years). Psychotropic medication use is common in TBI survivors. Higher TBI severity is associated with increased odds of psychotropic medication use. New use of psychotropic medications after TBI was associated with increased odds of late mortality. Our results highlight the need for early identification of potential psychiatric sequelae and psychiatric evaluation in TBI survivors.
Tài liệu tham khảo
Access Economics (2009) The economic cost of spinal cord injury and traumatic brain injury in Australia. Report by Access Economics Pty Limited for The Victorian Neurotrauma Initiative, Canberra
Albrecht JS, Mullins DC, Smith GS, Rao V (2017) Psychotropic medication use among medicare beneficiaries following traumatic brain injury. Am J Geriatr Psychiatry 25(4):415–424
Bilgic B, Baral-Kulaksizoglu I, Hanagasi H, Saylan M, Aykutlu E, Gurvit H, Emre M (2004) Obsessive-compulsive disorder secondary to bilateral frontal damage due to a closed head injury. Cogn Behav Neurol 17(2):118–120
Colantonio A, Escobar MD, Chipman M, McLellan B, Austin P, Mirabella G, Ratcliff G (2008) Predictors of postacute mortality following traumatic brain injury in a seriously injured population. Journal of Trauma: Injury, Infection & Critical Care 64(4):876–882
Deb S, Koutzoukis C, Ali I, Psych MRC, McCarthy G, Psych MRC (1999) Rate of psychiatric illness 1 year after traumatic brain injury. Am J Psychiatry 156(3):374–378
Diaz AP, Schwarzbold ML, Thais ME et al (2012) Psychiatric disorders and health-related quality of life after severe traumatic brain injury: a prospective study. J Neurotrauma 29(6):1029–1037
Dikmen SS, Bombardier CH, Machamer JE, Fann JR, Temkin NR (2004) Natural history of depression in traumatic brain injury. Arch Phys Med Rehabil 85(9):1457–1464
Fann JR (1997) Traumatic brain injury and psychiatry. J Psychosom Res 43(4):335–343
Fann JR, Burington B, Leonetti A, Jaffe K, Katon WJ, Thompson RS (2004) Psychiatric illness following traumatic brain injury in an adult healthMaintenance organization population. Arch Gen Psychiatry 61(1):53–61
Fann JR, Katon WJ, Uomoto JM, Esselman PC (1995) Psychiatric disorders and functional disability in outpatients with traumatic brain injuries. Am J Psychiatry 152(10):1493
Fujii D, Ahmed I (2002) Characteristics of psychotic disorder due to traumatic brain injury: an analysis of case studies in the literature. J Neuropsychiatry Clin Neurosci 14(2):130–140
Gualtieri CT (1995) The problem of mild brain injury. Neuropsychiatry Neuropsychol Behav Neurol 8(2):127–136
Hammond FM, Barrett RS, Shea T, Seel RT, McAlister TW, Kaelin D, Ryser DK, Corrigan JD, Cullen N, Horn SD (2015) Psychotropic medication use during inpatient rehabilitation for traumatic brain injury. Arch Phys Med Rehabil 96(8, Supplement):S256-S273.e14
James SL, Theadom A, Ellenbogen RG et al (2019) Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol 18(1):56–87
Jorge RE (1993) Secondary mania following traumatic brain injury. Am J Psychiatry 150(6):916
Jorge RE, Acion L, Starkstein SE, Magnotta V (2007) Hippocampal volume and mood disorders after traumatic brain injury. Biol Psychiat 62(4):332–338
Jorge RE, Robinson RG, Moser D, Tateno A, Crespo-Facorro B, Arndt S (2004) Major depression following traumatic brain injury. Arch Gen Psychiatry 61(1):42–50
Jorge RE, Starkstein SE, Arndt S, Moser D, Crespo-Facorro B, Robinson RG (2005) Alcohol misuse and mood disorders following traumatic brain injury. Arch Gen Psychiatry 62(7):742–749
Keene AR, Cullen DJ (1983) Therapeutic Intervention Scoring System: update 1983. Crit Care Med 11(1):1–3
Knaus WA, Draper EA, Wagner DP, Zimmerman JE (1985) APACHE II: a severity of disease classification system. Crit Care Med 13(10):818–829
Kohnen RF, Gerritsen DL, Smals OM, Lavrijsen JCM, Koopmans RTCM (2018) Prevalence of neuropsychiatric symptoms and psychotropic drug use in patients with acquired brain injury in long-term care: a systematic review. Brain Inj 32(13–14):1591–1600
Koponen S, Taiminen T, Portin R, Himanen L, Isoniemi H, Heinonen H, Hinkka S, Tenovuo O (2002) Axis I and II psychiatric disorders after traumatic brain injury: a 30-year follow-up study. Am J Psychiatry 159(8):1315–1321
Le Gall J-R, Lemeshow S, Saulnier F (1993) Simplified Acute Physiology Score (SAPS II) Based on a European / North American multicenter study. JAMA 270:2957–2963
Lewer D, O’Reilly C, Mojtabai R, Evans-Lacko S (2015) Antidepressant use in 27 European countries: associations with sociodemographic, cultural and economic factors. Br J Psychiatry 207(3):221–226
Marshall LF, Marshall SB, Klauber MR, Clark MB (1991) A new classification of head injury based on computerized tomography. J Neurosurg 75(11):S14–S22
Nikayin S, Rabiee A, Hashem MD, Huang M, Bienvenu OJ, Turnbull AE, Needham DM (2016) Anxiety symptoms in survivors of critical illness: a systematic review and meta-analysis. Gen Hosp Psychiatry 43:23–29
Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, Carbone PP (1982) Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 5(6):649–655
Parker AM, Sricharoenchai T, Raparla S, Schneck KW, Bienvenu OJ, Needham DM (2015) Posttraumatic stress disorder in critical illness survivors: a meta-analysis. Crit Care Med 43(5):1121–1129
Pickelsimer EE, Selassie AW, Sample PL, Heinemann WA, Gu JK, Veldheer LC (2007) Unmet service needs of persons with traumatic brain injury. J Head Trauma Rehabil 22(1):1–13
Rabiee A, Nikayin S, Hashem MD, Huang M, Dinglas VD, Bienvenu OJ, Turnbull AE, Needham DM (2016) Depressive symptoms after critical illness: a systematic review and meta-analysis. Crit Care Med 44(9):1744–1753
Raj R, Bendel S, Reinikainen M et al (2018) Temporal trends in healthcare costs and outcome following ICU admission after traumatic brain injury. Crit Care Med 46(4):e302–e309
van Reekum R, Bogalo I, Finlayson MAJ, Garner S, Links PS (1996) Psychiatric disorders after traumatic brain injury. Brain Inj 10(5):319–328
van Reekum R, Cohen T, Wong J (2000) Can traumatic brain injury cause psychiatric disorders? JNP 12(3):316–327
Reinikainen M, Mussalo P, Hovilehto S, Uusaro A, Varpula T, Kari A, Pettilä V, Finnish Intensive Care Consortium (2012) Association of automated data collection and data completeness with outcomes of intensive care. A new customised model for outcome prediction. Acta Anaesthesiol Scand 56(9):1114–1122
Richter JC, Waydhas C, Pajonk F-G (2006) Incidence of posttraumatic stress disorder after prolonged surgical intensive care unit treatment. Psychosomatics 47(3):223–230
Sachdev P, Smith JS, Cathcart S (2001) Schizophrenia-like psychosis following traumatic brain injury: a chart-based descriptive and case-control study. Psychol Med 31(2):231–9 (Cambridge)
Schwarzbold M, Diaz A, Martins ET, Rufino A, Amante LN, Thais ME, Quevedo J, Hohl A, Linhares MN, Walz R (2008) Psychiatric disorders and traumatic brain injury. Neuropsychiatr Dis Treat 4(4):797–816
Wang S, Mosher C, Perkins AJ, Gao S, Lasiter S, Khan S, Boustani M, Khan B (2017) Post-intensive care unit psychiatric comorbidity and quality of life. J Hosp Med 12(10):831–835
Whelan-Goodinson R, Ponsford J, Johnston L, Grant F (2009) Psychiatric disorders following traumatic brain injury: their nature and frequency. J Head Trauma Rehabil 24(5):324
Finnish Statistics on Medicines 2013. Finnish Medicines Agency Fimea and Social Insurance Institution, Helsinki, Finland