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Psychotropic Medication After Intensive Care Unit-Treated Pediatric Traumatic Brain Injury

Era D Mikkonen1, Markus B Skrifvars2, Matti Reinikainen3

  • 1Department of Anesthesiology, Intensive Care and Pain Medicine, Helsinki University Hospital, University of Helsinki, Helsinki, Finland; Department of Emergency Care and Services, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.

Pediatric Neurology
|September 11, 2020
PubMed

Insights

One-fifth of pediatric patients with traumatic brain injury (TBI) received psychotropic medications post-ICU treatment. Older age, particularly in adolescents with moderate disability, increased the likelihood of psychotropic use following TBI.

Area of Science:

  • Pediatric Neurology
  • Neurocritical Care
  • Psychopharmacology

Background:

  • Traumatic brain injury (TBI) in children can lead to long-term neurological and behavioral changes.
  • Psychotropic medication use following pediatric TBI is a significant concern, yet risk factors are not well understood.
  • Understanding post-TBI psychotropic needs is crucial for effective pediatric care.

Purpose of the Study:

  • To determine the incidence of psychotropic medication use in children after intensive care unit (ICU) treatment for TBI.
  • To identify risk factors associated with psychotropic medication initiation post-pediatric TBI.
  • To explore patterns of psychotropic use based on age and injury severity.

Main Methods:

  • Data linkage of Finnish ICU, medication reimbursement, and electronic health records.
  • Analysis of 248 pediatric patients (5-17 years) treated for TBI in Finnish university hospitals (2003-2013).
  • Multivariable logistic regression to identify factors associated with new psychotropic prescriptions within six months post-TBI, excluding pre-existing users.

Main Results:

  • 19% (46/248) of pediatric TBI patients initiated psychotropic medication.
  • Higher age was significantly associated with increased overall psychotropic use, antidepressant, and antipsychotic use.
  • Adolescents (12-17 years) with moderate six-month post-TBI disability had the highest psychotropic medication prevalence (45%).

Conclusions:

  • Psychotropic medication is prescribed to a substantial proportion of children following ICU-treated TBI.
  • Age is a key factor influencing psychotropic use, with older children and adolescents being more likely to receive these medications.
  • Post-TBI psychotropic needs appear multifactorial, not solely determined by TBI characteristics.
Abstract

Keywords:
AdolescentChildIntensive care unitsPopulation at riskPsychoactive agentsTraumatic brain injury

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