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Benzodiazepines increase the likelihood of both infectious and thrombotic complications

Edward Skicki1, Madison Morgan, Catherine Brown

  • 1From the Trauma and Acute Care Surgery, Penn Medicine Lancaster General Health, Lancaster, Pennsylvania.

The Journal of Trauma and Acute Care Surgery
|June 18, 2021
PubMed
Abstract

Insights

Benzodiazepines (BZDs) in trauma patients increase the risk of infectious and thrombotic complications. Infections in these patients further elevate the likelihood of thrombotic events, highlighting a critical link between BZD use and adverse outcomes.

Area of Science:

  • Immunology
  • Trauma Surgery
  • Pharmacology

Background:

  • Benzodiazepines (BZDs) modulate immune responses by inhibiting proinflammatory cytokines, potentially increasing infection risk.
  • Infections are known to elevate the risk of thrombotic complications.
  • The combined impact of BZDs and infection on trauma patient outcomes requires investigation.

Purpose of the Study:

  • To investigate the association between benzodiazepine (BZD) use and the incidence of infectious and thrombotic complications in trauma patients.
  • To determine if infections in BZD-positive trauma patients further increase thrombotic complication rates.

Main Methods:

  • Retrospective analysis of the Pennsylvania Trauma Outcome Study database (2003-2018).
  • Inclusion of trauma patients with positive urine drug screens (UDS) for BZDs.
  • Logistic regression models were used to assess the impact of BZDs on infectious and thrombotic complications, controlling for covariates.

Main Results:

  • Patients with BZDs on admission UDS showed significantly higher rates of both infectious (3.33% vs. 1.76%) and thrombotic (2.84% vs. 1.62%) complications.
  • Multivariate analysis confirmed that BZDs significantly increased the odds of both infectious and thrombotic complications.
  • Trauma patients with BZDs who developed infections had 1.65 times higher odds of experiencing thrombotic complications.

Conclusions:

  • Benzodiazepine (BZD) use in trauma patients is associated with increased odds of infectious and thrombotic complications.
  • Infectious complications in BZD-positive trauma patients further elevate the risk of thrombotic events.

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