Background

Our aim was to assess the occurrence and risk factors for psychotropic medication use after pediatric traumatic brain injury treated in the intensive care unit.

Methods

We combined data from the Finnish Intensive Care Consortium database, data on reimbursed medications from the Social Insurance Institute, and individual electronic health care data. We analyzed data on children aged five to 17 years treated for traumatic brain injury in intensive care units of four university hospitals in Finland during 2003 to 2013 and being alive six months after injury with no history of psychotropic medication use before traumatic brain injury.

Results

We identified 248 patients of whom 46 (19%) were prescribed a new psychotropic medication after traumatic brain injury. In multivariable logistic regression, a higher age associated with a higher probability for use of any psychotropic medication. Subgroup analyses showed that higher age associated with an increased risk of antidepressant and antipsychotic use but with a decreased risk of stimulant use. Apart from age, we found no other clinical, radiological, or treatment-related factors that significantly associated with subsequent use of psychotropics. Psychotropic medication was most common (45%) in children aged 12 to 17 years and had moderate disability at six-month follow-up.

Conclusions

One fifth of children treated in the intensive care unit for traumatic brain injury were prescribed a new psychotropic medication during a median follow-up of three years and five months. Psychotropic medication was most common among teenagers with moderate post-traumatic disability. The need and use of psychotropics postinjury seem multifactorial and not related to any traumatic brain injury type.

中文翻译：

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重症监护病房治疗小儿创伤性脑损伤后的精神药物。

背景

我们的目的是评估在重症监护室治疗的小儿创伤性脑损伤后使用精神药物的发生率和风险因素。

方法

我们结合了芬兰重症监护联盟数据库的数据、社会保险协会的报销药物数据以及个人电子医疗保健数据。我们分析了 2003 年至 2013 年在芬兰四所大学医院的重症监护病房接受外伤性脑损伤治疗的 5 至 17 岁儿童的数据，这些儿童在受伤后六个月还活着，在外伤性脑损伤前没有使用精神药物的历史。

结果

我们确定了 248 名患者，其中 46 名 (19%) 在创伤性脑损伤后服用了一种新的精神药物。在多变量逻辑回归中，年龄越大，使用任何精神药物的可能性越大。亚组分析表明，较高的年龄与使用抗抑郁药和抗精神病药的风险增加有关，但与使用兴奋剂的风险降低有关。除年龄外，我们没有发现与随后使用精神药物显着相关的其他临床、放射学或治疗相关因素。精神药物在 12 至 17 岁的儿童中最常见 (45%)，并且在 6 个月的随访中出现中度残疾。

结论

在重症监护室接受外伤性脑损伤治疗的儿童中，有五分之一在中位随访时间为三年零五个月期间服用了一种新的精神药物。精神药物在有中度创伤后残疾的青少年中最为常见。伤后精神药物的需要和使用似乎是多因素的，与任何创伤性脑损伤类型无关。