Gabapentin Role in Improving outcome of Patients with Severe Traumatic Brain Injury (GRIPs TBI)

Objective: We aim to describe GBP utilization among patients with sTBI and compare the characteristics and outcomes of patients with sTBI who received gabapentin (GBP) versus those who did not (NGBP). Background: Intracranial hypertension, anxiety, agitation, pain, paroxysmal sympathetic hyperactivity (PSH) and seizures lead to use of prolonged and large dosages of sedating intravenous infusion medication (SIIM) in severe TBI (sTBI). Gabapentin (GBP) is a potential adjunct or alternative for this role. There are no studies analyzing the GBP utility and feasibility in the setting of acute sTBI. Design/Methods: A retrospective cohort study was conducted from January 1,2016 to September30,2017. Patients with sTBI were included. Patient demographic, clinical, radiographic and outcome characteristics were collected. Primary outcome was description of GBP utilization characteristics of the GBP cohort. Secondary outcomes included comparison of ICU and Hospital Length of Stay (LOS) doses and duration of SIIM, discharge disposition, out-patient disposition, in-patient mortality and 90-day readmission between GBP and NGBP cohorts. Results: A total of 63 patients were included in the study. Thirteen(21%) patients received GBP with the mean initial dose of 165mg±118mg initiated at a mean of 87hours±63hours. The mean dose per day was 775mg±663mg. Most common dose adjustment method was by increasing by 100mg or doubling GBP. Ten(77%) of the patients had their sedation weaned off after initiation of GBP. There were no GBP-related adverse events or mortality. The GBP group had longer ICU and HLOS, higher total dose of propofol, fentanyl and oxycodone. There was a trend towards lower mortality in the GBP cohort. Conclusions: This is the first study of adult patients in the NSICU describing the feasibility and utility of GBP for sTBI. We further described the utilization characteristics of GBP for this population. Further prospective studies should be done to establish the utility of GBP in improving outcomes of sTBI patients. Disclosure: Dr. Proctor has nothing to disclose. Dr. Stephens-Gibson has nothing to disclose. Dr. McEuen has nothing to disclose. Dr. Leon has nothing to disclose. Dr. Nobleza has nothing to disclose.