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Effectiveness of calcium channel blockers in traumatic brain injury patients requiring operative intervention
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Effectiveness of calcium channel blockers in traumatic brain injury patients requiring operative intervention
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Journal Article
Effectiveness of calcium channel blockers in traumatic brain injury patients requiring operative intervention
2025
Overview
In patients with traumatic brain injury (TBI), calcium channel blockers (CCBs) may be used in the early phase to manage hypertension. However, these medications may exacerbate secondary brain injury via hypotension and cerebral vasodilation, blunting Cushing's reflex. We hypothesized that preoperative CCB use does not improve outcomes.
A retrospective study (2017–2023) at a Level 1 Trauma Center includes adults undergoing craniotomy or craniectomy within 6 h of arrival. Patients were grouped by CCB exposure. Outcomes included mortality, Glasgow Outcome Scale (GOS), ICU days, hospital length of stay, and discharge location.
Of 105 patients, 33 received CCBs. Groups were similar in injury severity and initial GCS. Preoperative CCB was linked to significantly higher mortality (46.9 % vs. 23.3 %, p = 0.029) without significant GOS differences (p = 0.135). Other outcomes showed no significant differences.
Preoperative CCB use in TBI patients may be associated with higher mortality without improving outcomes.
•TBI patients receiving preoperative CCBs showed significantly higher mortality.•Preoperative CCB use in TBI linked to non-significant change in functional outcomes.•Findings support cautious BP management and reevaluation of CCB use in TBI.
Publisher
Elsevier Inc,Elsevier Limited
Subject
/ Aged
/ Brain
/ Brain Injuries, Traumatic - complications
/ Brain Injuries, Traumatic - mortality
/ Brain Injuries, Traumatic - surgery
/ Calcium Channel Blockers - adverse effects
/ Calcium Channel Blockers - therapeutic use
/ Female
/ Hematoma
/ Humans
/ Length of Stay - statistics & numerical data
/ Male
/ Patients
/ Surgery
/ Trauma
