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

- This is a retrospective study of trauma patients with severe isolated traumatic brain injury at a level 1 trauma center.
- This study compares patients with pre-injury polypharmacy use with those without.
- Pre-injury polypharmacy use was associated with a 2.3 times greater risk for mortality in patients with isolated severe traumatic brain injury.

BackgroundThe 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.MethodsA 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.ResultsThere 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).ConclusionsPre-injury PPM increases mortality in patients with isolated severe TBI. This knowledge may provide opportunities for intervention in this population.