Pre-injury Polypharmacy Predicts Mortality in Isolated Severe Traumatic Brain Injury Patients

Abstract Background The use of five or more medications is defined as polypharmacy (PPM). The clinical impact of PPM on the isolated severe traumatic brain injury (TBI) patient has not been defined. Methods A retrospective cohort study was performed at our academic Level 1 trauma center examining patients with isolated TBI. Pre-injury medications were reviewed and in-hospital mortality was the primary measured outcome. Results There were 698 patients with an isolated TBI over the 5-year study period. 177 (25.4%) patients reported pre-injury PPM. There were 18 (10.2%) deaths in the PPM cohort and 24 (4.6%) deaths in the non-PPM cohort (p < .0001). Step-wise logistic regression analysis revealed a 2.3 times greater risk of mortality in the PPM patients (p = 0.019). Conclusion Pre-injury PPM increases mortality in patients with isolated severe TBI. This knowledge may provide opportunities for intervention in this population.