创伤性脑损伤(TBI)与多个领域的健康问题有关,据报道,TBI患者的药物使用率很高。然而,由于方法上的限制,先前的证据很少。因此,我们的目的是研究在基于人群的TBI患者队列中使用广泛的药物来解决疼痛和躯体疾病。并将其与性别和年龄相匹配的队列进行比较。我们还研究了患者的因素,如性别,年龄,TBI严重程度与药物使用相关。
■我们评估了瑞典全国范围内的登记册,以包括2006年至2012年期间在医院或专科门诊接受TBI治疗的所有个人。我们在12个月前检查了八种不同非精神药物类别的处方,12个月后,TBI。我们应用固定效应模型将TBI患者与匹配人群队列进行比较。我们还按性别对TBI患者进行了分层,年龄,TBI严重程度,并使用广义线性模型进行比较。
■我们确定了239,425名患有TBI事件的个体和239,425名匹配的个体。TBI患者更可能使用任何药物[赔率比(OR)=2.03,95%置信区间(CI)=2.00-2.05],以多重用药(OR=1.96,95%CI=1.90-2.02),并在TBI之前使用八种药物中的每一种,与匹配的人群队列相比。在TBI之后,TBI患者更可能使用任何药物(OR=1.83,95%CI=1.80-1.86),与多重用药(OR=1.74,95%CI=1.67-1.80),并使用所有药物类别,尽管差异减弱。然而,TBI后,抗生素/抗病毒药物(OR=2.02,95%CI=1.99-2.05)和NSAIDs/抗风湿药(OR=1.62,95%CI=1.59-1.65)的差异增加.我们还发现,女性和老年患者比男性和年轻患者更有可能在TBI后使用药物,分别。TBI较严重的患者与TBI较不严重的患者相比,抗生素/抗病毒药和NSAIDs/抗风湿药的使用增加。
■放在一起,我们的结果表明TBI患者的整体健康状况不佳,建议医学随访应该是常规的,尤其是女性的TBI,并包括对药物使用的审查,以解决潜在的多重用药。
UNASSIGNED: Traumatic brain injury (TBI) is associated with health problems across multiple domains and TBI patients are reported to have high rates of medication use. However, prior evidence is thin due to methodological limitations. Our aim was thus to examine the use of a wide spectrum of medications prescribed to address pain and somatic conditions in a population-based cohort of TBI patients, and to compare this to a sex- and age-matched cohort. We also examined how patient factors such as sex, age, and TBI severity were associated with medication use.
UNASSIGNED: We assessed Swedish nationwide registers to include all individuals treated for TBI in hospitals or specialist outpatient care between 2006 and 2012. We examined dispensed prescriptions for eight different non-psychotropic medication classes for the 12 months before, and 12 months after, the TBI. We applied a fixed-effects model to compare TBI patients with the matched population cohort. We also stratified TBI patients by sex, age, TBI severity and carried out comparisons using a generalized linear model.
UNASSIGNED: We identified 239,425 individuals with an incident TBI and 239,425 matched individuals. TBI patients were more likely to use any medication [Odds ratio (OR) = 2.03, 95% Confidence Interval (CI) = 2.00-2.05], to present with polypharmacy (OR = 1.96, 95% CI = 1.90-2.02), and to use each of the eight medication classes before their TBI, as compared to the matched population cohort. Following the TBI, TBI patients were more likely to use any medication (OR = 1.83, 95% CI = 1.80-1.86), to present with polypharmacy (OR = 1.74, 95% CI = 1.67-1.80), and to use all medication classes, although differences were attenuated. However, differences increased for antibiotics/antivirals (OR = 2.02, 95% CI = 1.99-2.05) and NSAIDs/antirheumatics (OR = 1.62, 95% CI = 1.59-1.65) post-TBI. We also found that females and older patients were more likely to use medications after their TBI than males and younger patients, respectively. Patients with more severe TBIs demonstrated increased use of antibiotics/ antivirals and NSAIDs/antirheumatics than those with less severe TBIs.
UNASSIGNED: Taken together, our results point to poor overall health in TBI patients, suggesting that medical follow-up should be routine, particularly in females with TBI, and include a review of medication use to address potential polypharmacy.