{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T06:50:09Z","timestamp":1791528609173,"version":"4.3.4"},"reference-count":19,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Use of nonsteroidal anti\u2010inflammatory drugs (NSAIDs) after a traumatic brain injury (TBI) is controversial due to potential worsening of an intracranial hemorrhage (ICH). This study evaluated if NSAID use within 14\u2009days of TBI was associated with a clinically significant progression of intracranial bleed (PIB).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective, propensity score\u2010weighted study was conducted in adult patients with a TBI admitted to an American College of Surgeons Certified Level I Trauma Center. The NSAID group included patients who received at least one dose of an NSAID within 14\u2009days of injury while admitted. The control group included patients who did not receive NSAIDs. The primary end point was incidence of a clinically significant PIB (decrease in the Glasgow Coma Score (GCS) &gt;\u20092 and an increased or new ICH). Secondary outcomes included need for additional neurosurgical intervention and PIB on imaging regardless of GCS change.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      978 patients were included: 284 in the NSAID group and 694 in the control group. Most patients had an Abbreviated Injury Score head &gt;\u20092 (88%) and a subdural hematoma (57%). Fifty\u2010two percent of patients had a mixed bleed. A clinically significant PIB occurred in 0.35% in the NSAID group and 1.2% in the control group (Hazards Ratio 0.1, 95% Confidence Interval 0.01\u20130.82,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.032). There was no difference in additional neurosurgical operations or PIB regardless of GCS change. In the NSAID group, there was no significant difference in time from admission to NSAID administration between patients who experienced a PIB and those who did not have a PIB (1.9\u2009days vs. 4.7\u2009days, respectively,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.06).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this single\u2010center, retrospective, propensity score\u2010weighted study, NSAIDs were not associated with an increased risk of clinically significant PIB in patients with acute TBI when administered within 14\u2009days of injury. NSAIDs appear safe in the acute phase post\u2010TBI. Prospective studies are needed to validate our results.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/phar.70199","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T08:02:10Z","timestamp":1789113730000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Safety of Nonsteroidal Anti\u2010Inflammatory Drug Use in Traumatic Brain Injury"],"prefix":"10.1002","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4042-9501","authenticated-orcid":false,"given":"Jennifer","family":"Beavers","sequence":"first","affiliation":[{"name":"Department of Pharmaceutical Services Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0405-7878","authenticated-orcid":false,"given":"Mary Katherine Cella","family":"Shultz","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Services Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leanne","family":"Atchison","sequence":"additional","affiliation":[{"name":"Medical Affairs, Cytokinetics  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9258-0302","authenticated-orcid":false,"given":"Cara","family":"Lwin","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7176-8346","authenticated-orcid":false,"given":"Dandan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5981-3231","authenticated-orcid":false,"given":"Silky","family":"Chotai","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery Cleveland Clinic Foundation  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1918-1329","authenticated-orcid":false,"given":"Andrew J.","family":"Medvecz","sequence":"additional","affiliation":[{"name":"Division of Acute Care Surgery Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7886-6398","authenticated-orcid":false,"given":"Robel","family":"Beyene","sequence":"additional","affiliation":[{"name":"Division of Acute Care Surgery Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1136-0250","authenticated-orcid":false,"given":"Michael C.","family":"Smith","sequence":"additional","affiliation":[{"name":"Division of Acute Care Surgery Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2419-2102","authenticated-orcid":false,"given":"Bradley M.","family":"Dennis","sequence":"additional","affiliation":[{"name":"Division of Acute Care Surgery Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5400-9752","authenticated-orcid":false,"given":"Susan","family":"Hamblin","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice Lipscomb University College of Pharmacy  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Best Practices Guidelines for Acute Pain Management in Trauma Patients","author":"ACS Trauma Quality Programs","year":"2020"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s10194\u2010019\u20101051\u20107"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.3310\/hta14170"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542\u2010200512000\u201000025"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.1552\u20104604.1995.tb04050.x"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002\u20109343(99)00114\u2010X"},{"key":"e_1_2_11_8_1","unstructured":"\u201c17.07 NSAID Use in Blunt Head Injury Patients With Intracranial Hemorrhage: Are Complications Observed? \u201dAcademic Surgical Congress Abstracts Archive accessed July 23 2024 https:\/\/www.asc\u2010abstracts.org\/abs2020\/17\u201007\u2010nsaid\u2010use\u2010in\u2010blunt\u2010head\u2010injury\u2010patients\u2010with\u2010intracranial\u2010hemorrhage\u2010are\u2010complications\u2010observed\/."},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2014.05.027"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2015.11.012"},{"key":"e_1_2_11_11_1","doi-asserted-by":"crossref","unstructured":"H. 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D.Isbell J.Klugh et\u00a0al. \u201cHemorrhage Progression in Traumatic Brain Injury Occurs Early and Is Not Increased by Administration of Naproxen \u201dhttps:\/\/doi.org\/10.2139\/ssrn.4360547.","DOI":"10.2139\/ssrn.4360547"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.27.8.1304"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc11292\/tables\/1"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.3171\/2019.4.jns19252"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ta.0000151671.35280.8b"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1089\/neur.2022.0042"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.3171\/2021.2.peds2115"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00234\u2010010\u20100659\u20108"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.2002.96.1.0109"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.3171\/2009.5.jns081369"}],"container-title":["Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/phar.70199","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/phar.70199","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/phar.70199","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T06:10:36Z","timestamp":1791526236000},"score":1,"resource":{"primary":{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/10.1002\/phar.70199"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,11]]},"references-count":19,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/phar.70199"],"URL":"https:\/\/doi.org\/10.1002\/phar.70199","archive":["Portico"],"relation":{},"ISSN":["0277-0008","1875-9114"],"issn-type":[{"value":"0277-0008","type":"print"},{"value":"1875-9114","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,11]]},"assertion":[{"value":"2026-01-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70199"}}