Association of Angiotensin-Converting Enzyme Inhibitors with Increased Mortality Among Patients with Isolated Severe Traumatic Brain Injury
Document Type
Article
Publication Date
6-11-2019
Publication Title
Neurocritical Care
First page number:
1
Last page number:
7
Abstract
Background: Traumatic brain injury (TBI) is associated with one-third of all deaths from trauma. Preinjury exposure to cardiovascular drugs may affect TBI outcomes. Angiotensin-converting enzyme inhibitors (ACEIs) exacerbate brain cell damage and worsen functional outcomes in the laboratory setting. β-blockers (BBs), however, appear to be associated with reduced mortality among patients with isolated TBI. Objective: Examine the association between preinjury ACEI and BB use and clinical outcome among patients with isolated TBI. Methods: A retrospective cohort study of patients age ≥ 40 years admitted to an academic level 1 trauma center with isolated TBI between January 2010 and December 2014 was performed. Isolated TBI was defined as a head Abbreviated Injury Scale (AIS) score ≥ 3, with chest, abdomen, and extremity AIS scores ≤ 2. Preinjury medication use was determined through chart review. All patients with concurrent BB use were initially excluded. In-hospital mortality was the primary measured outcome. Results: Over the 5-year study period, 600 patients were identified with isolated TBI who were naive to BB use. There was significantly higher mortality (P = .04) among patients who received ACEI before injury (10 of 96; 10%) than among those who did not (25 of 504; 5%). A multivariate stepwise logistic regression analysis revealed a threefold increased risk of mortality in the ACEI cohort (P...) (see abstract in article).
Keywords
Angiotensin-converting enzyme inhibitor; β-Blockers; Isolated; Mortality; Traumatic brain injury
Disciplines
Enzymes and Coenzymes | Neurology | Trauma
Language
English
Repository Citation
Catapano, J. S.,
Chapman, A. J.,
Dull, M.,
Abbatematteo, J. M.,
Horner, L. P.,
Godzik, J.,
Brigeman, S.,
Morgan, C. D.,
Whiting, A. C.,
Lu, M.,
Zabramski, J. M.,
Fraser, D. R.
(2019).
Association of Angiotensin-Converting Enzyme Inhibitors with Increased Mortality Among Patients with Isolated Severe Traumatic Brain Injury.
Neurocritical Care
1-7.
http://dx.doi.org/10.1007/s12028-019-00755-y