Effectiveness of calcium channel blockers in traumatic brain injury patients requiring operative intervention.

INTRODUCTION

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.

METHOD: 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.

RESULT: 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.

CONCLUSION

Preoperative CCB use in TBI patients may be associated with higher mortality without improving outcomes.