Pharmacological Management of Acute Spinal Cord Injury: A Longitudinal Multi-Cohort Observational Study
👨🔬 👩🔬 Authors:
Catherine R. Jutzeler, Lucie Bourguignon, Bobo Tong, Elias Ronca, Eric Bailey, Noam Y. Harel, Fred Geisler, Adam R. Ferguson, Brian K. Kwon, Jacquelyn J. Cragg, Lukas Grassner, and John L.K. Kramer
📝 Short summary: Nearly every individual sustaining spinal cord injury receives multiple types and classes of medications to manage a litany of secondary complications. Prior clinical studies and evidence from animal models suggest that several of these medications could enhance or impede endogenous neurological recovery. However, there is a knowledge gap surrounding the acute pharmacological management of spinal cord injury. Objective: To determine the types of medications commonly administered, alone or in combination, in the acute phase of spinal cord injury. We conducted an analysis of two largescale cohorts to determine what constitutes “standards of acute pharmacological care” after spinal cord injury. Concomitant medication use (i.e., non-randomized medications), including dosage, timing and reason for administration, was tracked. Descriptive statistics were used to describe the medications administered within the first 90 days after spinal cord injury. Across 1895 individuals with spinal cord injury, over 770 unique medications were administered within the first month after injury. On average, patients received 20 unique medications (range 1-58) – often in a combinatorial or overlapping fashion (i.e., polypharmacy). Approximately 10% of medications were administered acutely as prophylaxis (e.g., pain, infections). Our study revealed a high degree of polypharmacy in the acute stages of spinal cord injury, with potential to both positively and negatively impact neurological recovery.
📖 Link to paper: Peer-reviewed
🖥️ Link to web application: RxSCI Platform
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This study was funded by the Swiss National Science Foundation (Ambizione Grant #PZ00P3_186101, Jutzeler) and Wings for Life Research Foundation (#2017_044, Jutzeler and Kramer).