Vasopressors in traumatic brain injury: Quantifying their effect on mortality

Background: The benefits of vasopressor (VP) use to improve clinical outcomes in traumatic brain injury (TBI) is unknown. We sought to characterize the use of VP in TBI patients and evaluate its impact on mortality. Methods: A retrospective review was conducted of all TBI patients admitted to an ICU at a Level I trauma center from January 2014 to August 2016. Patients who had any VP administered (VP+) were compared to those who did not (VP-). Results: Among the 556 patients analyzed, 83 (14.9%) received VP. The overall mortality was 9.2%, significantly higher in the VP + cohort (42.2% vs. 3.4%, p < 0.01). After adjusting for confounding factors, VP + patients had a significantly higher risk for in-hospital mortality (Adjusted Hazard Ratio: 2.77, adjusted p = 0.01). Conclusion: Although VP may be temporarily useful in avoiding secondary insult to the brain in TBI patients, their use is not associated with improved survival. (c) 2020 Elsevier Inc. All rights reserved.