Drug intoxication and increased mortality in anoxic brain injury
Dharaiya D, Modi S, Schultz L, and Varelas P. Drug intoxication and increased mortality in anoxic brain injury. Neurocrit Care 2017; 27(2):S29.
Introduction Intoxication by central nervous system (CNS) depressant drugs can lead to anoxic brain injury by cardiac or respiratory arrest. We tested the hypothesis whether intoxication by these drugs contributes to mortality in acute anoxic brain injury Methods We utilized healthcare cost and utilization project databases (Nationwide Inpatient Sample and Kids' Inpatient Database) to obtain patients admitted with diagnosis of anoxic brain injury. Patients with drug intoxication (opioid, alcohol, sedative/hypnotic drugs) were identified. Regression analysis was used to assess relationship between drug intoxication status to in-hospital mortality. The regression model was adjusted for age, gender, chronic medical comorbidities, presence of cardiac arrest and hospital characteristics. Results We analyzed a total of 12,319 patients with anoxic brain injury out of which 197 (1.6%) had drug intoxication and 35% were reported to have cardiac arrest. Median age was 58 years and 54% patients were males. In-hospital mortality was 57%. Among the survivors, 20% underwent feeding tube placement and 15% had tracheostomy. Drug intoxication was a significant positive predictor of inhospital mortality with adjusted odds ratio 1.5 (1.1 - 2.1), p=0.01. Conclusions CNS depressant drug intoxication is associated with higher in-hospital mortality in patients with acute anoxic brain injury.