Risk for intracranial hemorrhage in individuals after mild traumatic brain injury who are taking serotonergic antidepressants
BackgroundSerotonergic antidepressants may predispose to bleeding, but little is known of the risk for traumatic intracranial bleeding.MethodsThis was a prospective case-control study of 218 patients with mild traumatic brain injuries (TBI) who were treated at a Finnish tertiary trauma hospital. Inj...
| Main Authors: | , , , , , |
|---|---|
| 格式: | 文件 |
| 语言: | English |
| 出版: |
Frontiers Media S.A.
2022-12-01
|
| 丛编: | Frontiers in Neurology |
| 主题: | |
| 在线阅读: | https://www.frontiersin.org/articles/10.3389/fneur.2022.952188/full |
| _version_ | 1828272722321342464 |
|---|---|
| author | Harri Isokuortti Grant L. Iverson Grant L. Iverson Jussi P. Posti Ksenia Berghem Anna-Kerttu Kotilainen Teemu M. Luoto |
| author_facet | Harri Isokuortti Grant L. Iverson Grant L. Iverson Jussi P. Posti Ksenia Berghem Anna-Kerttu Kotilainen Teemu M. Luoto |
| author_sort | Harri Isokuortti |
| collection | DOAJ |
| description | BackgroundSerotonergic antidepressants may predispose to bleeding, but little is known of the risk for traumatic intracranial bleeding.MethodsThis was a prospective case-control study of 218 patients with mild traumatic brain injuries (TBI) who were treated at a Finnish tertiary trauma hospital. Injury-related information and clinical findings were prospectively collected in the emergency department. Detailed pre-injury health history was collected from electronic medical records. Information on the use of serotonergic antidepressants was attained from the Finnish national prescription registry. All head CT scans were reviewed by a neuroradiologist based on the Common Data Elements. Cases were patients with traumatic intracranial hemorrhage on head CT. Controls were patients from the same cohort, but without traumatic intracranial lesions on CT. The proportion with traumatic intracranial bleeding for patients on serotonergic antidepressant medication was compared to the proportion for patients not on serotonergic medication.ResultsThe study cohort consisted of 24 cases with traumatic intracranial bleeding and 194 injured controls. The median age of the sample was 70 years (interquartile range = 50–83). One fifth (21.6%) of all the patients were taking a serotonergic antidepressant. Of the patients on an antidepressant, 10.6% (5/47) had an acute hemorrhagic lesion compared to 11.1% (19/171) of those who were not on an antidepressant (p = 0.927). In the regression analysis, traumatic intracranial hemorrhage was not associated with antidepressant use.ConclusionSerotonergic antidepressant use was not associated with an increased risk of traumatic intracranial hemorrhage after a mild TBI. The patients in this relatively small cohort were mostly middle-aged and older adults. These factors limit the generalizability of the results in younger patients with mild TBI. |
| first_indexed | 2024-04-13T06:10:29Z |
| format | Article |
| id | doaj.art-212fd901b0da4aa1b0b79a4f095e2be2 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-13T06:10:29Z |
| publishDate | 2022-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-212fd901b0da4aa1b0b79a4f095e2be22022-12-22T02:59:04ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-12-011310.3389/fneur.2022.952188952188Risk for intracranial hemorrhage in individuals after mild traumatic brain injury who are taking serotonergic antidepressantsHarri Isokuortti0Grant L. Iverson1Grant L. Iverson2Jussi P. Posti3Ksenia Berghem4Anna-Kerttu Kotilainen5Teemu M. Luoto6Department of Neurosurgery, Helsinki University Hospital and University of Helsinki, Helsinki, FinlandDepartment of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United StatesDepartment of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and the Schoen Adams Research Institute at Spaulding Rehabilitation, Charlestown, MA, United StatesNeurocenter, Department of Neurosurgery, and Turku Brain Injury Center, Turku University Hospital and University of Turku, Turku, FinlandMedical Imaging Centre, Department of Radiology, Tampere University Hospital, Tampere, FinlandDepartment of Surgery, Tampere University Hospital and Tampere University, Tampere, FinlandDepartment of Neurosurgery, Tampere University Hospital and Tampere University, Tampere, FinlandBackgroundSerotonergic antidepressants may predispose to bleeding, but little is known of the risk for traumatic intracranial bleeding.MethodsThis was a prospective case-control study of 218 patients with mild traumatic brain injuries (TBI) who were treated at a Finnish tertiary trauma hospital. Injury-related information and clinical findings were prospectively collected in the emergency department. Detailed pre-injury health history was collected from electronic medical records. Information on the use of serotonergic antidepressants was attained from the Finnish national prescription registry. All head CT scans were reviewed by a neuroradiologist based on the Common Data Elements. Cases were patients with traumatic intracranial hemorrhage on head CT. Controls were patients from the same cohort, but without traumatic intracranial lesions on CT. The proportion with traumatic intracranial bleeding for patients on serotonergic antidepressant medication was compared to the proportion for patients not on serotonergic medication.ResultsThe study cohort consisted of 24 cases with traumatic intracranial bleeding and 194 injured controls. The median age of the sample was 70 years (interquartile range = 50–83). One fifth (21.6%) of all the patients were taking a serotonergic antidepressant. Of the patients on an antidepressant, 10.6% (5/47) had an acute hemorrhagic lesion compared to 11.1% (19/171) of those who were not on an antidepressant (p = 0.927). In the regression analysis, traumatic intracranial hemorrhage was not associated with antidepressant use.ConclusionSerotonergic antidepressant use was not associated with an increased risk of traumatic intracranial hemorrhage after a mild TBI. The patients in this relatively small cohort were mostly middle-aged and older adults. These factors limit the generalizability of the results in younger patients with mild TBI.https://www.frontiersin.org/articles/10.3389/fneur.2022.952188/fullantithrombotic medicationanticoagulantsantidepressant agentsintracranial hemorrhagesbrain injuries |
| spellingShingle | Harri Isokuortti Grant L. Iverson Grant L. Iverson Jussi P. Posti Ksenia Berghem Anna-Kerttu Kotilainen Teemu M. Luoto Risk for intracranial hemorrhage in individuals after mild traumatic brain injury who are taking serotonergic antidepressants Frontiers in Neurology antithrombotic medication anticoagulants antidepressant agents intracranial hemorrhages brain injuries |
| title | Risk for intracranial hemorrhage in individuals after mild traumatic brain injury who are taking serotonergic antidepressants |
| title_full | Risk for intracranial hemorrhage in individuals after mild traumatic brain injury who are taking serotonergic antidepressants |
| title_fullStr | Risk for intracranial hemorrhage in individuals after mild traumatic brain injury who are taking serotonergic antidepressants |
| title_full_unstemmed | Risk for intracranial hemorrhage in individuals after mild traumatic brain injury who are taking serotonergic antidepressants |
| title_short | Risk for intracranial hemorrhage in individuals after mild traumatic brain injury who are taking serotonergic antidepressants |
| title_sort | risk for intracranial hemorrhage in individuals after mild traumatic brain injury who are taking serotonergic antidepressants |
| topic | antithrombotic medication anticoagulants antidepressant agents intracranial hemorrhages brain injuries |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.952188/full |
| work_keys_str_mv | AT harriisokuortti riskforintracranialhemorrhageinindividualsaftermildtraumaticbraininjurywhoaretakingserotonergicantidepressants AT grantliverson riskforintracranialhemorrhageinindividualsaftermildtraumaticbraininjurywhoaretakingserotonergicantidepressants AT grantliverson riskforintracranialhemorrhageinindividualsaftermildtraumaticbraininjurywhoaretakingserotonergicantidepressants AT jussipposti riskforintracranialhemorrhageinindividualsaftermildtraumaticbraininjurywhoaretakingserotonergicantidepressants AT kseniaberghem riskforintracranialhemorrhageinindividualsaftermildtraumaticbraininjurywhoaretakingserotonergicantidepressants AT annakerttukotilainen riskforintracranialhemorrhageinindividualsaftermildtraumaticbraininjurywhoaretakingserotonergicantidepressants AT teemumluoto riskforintracranialhemorrhageinindividualsaftermildtraumaticbraininjurywhoaretakingserotonergicantidepressants |