Eric Caliendo, Ryan Lowder, Matthew J McLaughlin, William D Watson, Katherine T Baum, Laura S Blackwell, Christine H Koterba, Kristen R Hoskinson, Sarah J Tlustos, Sudhin A Shah, Stacy J Suskauer, Brad G Kurowski
{"title":"小儿创伤性脑损伤后住院康复期间哌醋甲酯的使用：人群特征和处方模式。","authors":"Eric Caliendo, Ryan Lowder, Matthew J McLaughlin, William D Watson, Katherine T Baum, Laura S Blackwell, Christine H Koterba, Kristen R Hoskinson, Sarah J Tlustos, Sudhin A Shah, Stacy J Suskauer, Brad G Kurowski","doi":"10.1097/HTR.0000000000000889","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To understand how methylphenidate (MPH) is used in youth with traumatic brain injury (TBI) during inpatient pediatric rehabilitation.</p><p><strong>Setting: </strong>Inpatient pediatric rehabilitation.</p><p><strong>Participants: </strong>In total, 234 children with TBI; 62 of whom received MPH and 172 who did not. Patients were on average 11.6 years of age (range, 2 months to 21 years); 88 of 234 were female; the most common mechanism of injury was motor vehicle collision (49%); median (IQR) acute hospital length of stay (LOS) and inpatient rehabilitation LOS were 16 (10-29) and 23 (14-39), respectively; 51 of 234 were in a disorder of consciousness cognitive state at time of inpatient rehabilitation admission.</p><p><strong>Design: </strong>Multicenter, retrospective medical record review.</p><p><strong>Main measures: </strong>Patient demographic data, time to inpatient pediatric rehabilitation admission (TTA), cognitive state, MPH dosing (mg/kg/day).</p><p><strong>Results: </strong>Patients who received MPH were older (P = .011); TTA was significantly longer in patients who received MPH than those who did not (P =.002). The lowest recorded dose range by weight was 0.05 to 0.89 mg/kg/d, representing an 18-fold difference; the weight-based range for the maximum dose was 0.11 to 0.97 mg/kg/d, a 9-fold difference. Patients in lower cognitive states at admission (P = .001) and at discharge (P = .030) were more likely to receive MPH. Five patients had side effects known to be associated with MPH; no serious adverse events were reported.</p><p><strong>Conclusion: </strong>This multicenter study indicates that there is variable use of MPH during acute inpatient rehabilitation for children with TBI. Children who receive MPH tend to be older with lower cognitive states. Dosing practices are likely consistent with underdosing. Clinical indications for MPH use during inpatient pediatric rehabilitation should be better defined. The use of MPH, as well as its combination with other medications and treatments, during inpatient rehabilitation needs to be further explored.</p>","PeriodicalId":51442,"journal":{"name":"Language in Society","volume":"12 1","pages":"E122-E131"},"PeriodicalIF":2.0000,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11076004/pdf/","citationCount":"0","resultStr":"{\"title\":\"The Use of Methylphenidate During Inpatient Rehabilitation After Pediatric Traumatic Brain Injury: Population Characteristics and Prescribing Patterns.\",\"authors\":\"Eric Caliendo, Ryan Lowder, Matthew J McLaughlin, William D Watson, Katherine T Baum, Laura S Blackwell, Christine H Koterba, Kristen R Hoskinson, Sarah J Tlustos, Sudhin A Shah, Stacy J Suskauer, Brad G Kurowski\",\"doi\":\"10.1097/HTR.0000000000000889\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To understand how methylphenidate (MPH) is used in youth with traumatic brain injury (TBI) during inpatient pediatric rehabilitation.</p><p><strong>Setting: </strong>Inpatient pediatric rehabilitation.</p><p><strong>Participants: </strong>In total, 234 children with TBI; 62 of whom received MPH and 172 who did not. Patients were on average 11.6 years of age (range, 2 months to 21 years); 88 of 234 were female; the most common mechanism of injury was motor vehicle collision (49%); median (IQR) acute hospital length of stay (LOS) and inpatient rehabilitation LOS were 16 (10-29) and 23 (14-39), respectively; 51 of 234 were in a disorder of consciousness cognitive state at time of inpatient rehabilitation admission.</p><p><strong>Design: </strong>Multicenter, retrospective medical record review.</p><p><strong>Main measures: </strong>Patient demographic data, time to inpatient pediatric rehabilitation admission (TTA), cognitive state, MPH dosing (mg/kg/day).</p><p><strong>Results: </strong>Patients who received MPH were older (P = .011); TTA was significantly longer in patients who received MPH than those who did not (P =.002). The lowest recorded dose range by weight was 0.05 to 0.89 mg/kg/d, representing an 18-fold difference; the weight-based range for the maximum dose was 0.11 to 0.97 mg/kg/d, a 9-fold difference. Patients in lower cognitive states at admission (P = .001) and at discharge (P = .030) were more likely to receive MPH. Five patients had side effects known to be associated with MPH; no serious adverse events were reported.</p><p><strong>Conclusion: </strong>This multicenter study indicates that there is variable use of MPH during acute inpatient rehabilitation for children with TBI. Children who receive MPH tend to be older with lower cognitive states. Dosing practices are likely consistent with underdosing. Clinical indications for MPH use during inpatient pediatric rehabilitation should be better defined. The use of MPH, as well as its combination with other medications and treatments, during inpatient rehabilitation needs to be further explored.</p>\",\"PeriodicalId\":51442,\"journal\":{\"name\":\"Language in Society\",\"volume\":\"12 1\",\"pages\":\"E122-E131\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2024-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11076004/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Language in Society\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/HTR.0000000000000889\",\"RegionNum\":2,\"RegionCategory\":\"文学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/8/14 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"LINGUISTICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Language in Society","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/HTR.0000000000000889","RegionNum":2,"RegionCategory":"文学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/8/14 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"LINGUISTICS","Score":null,"Total":0}
The Use of Methylphenidate During Inpatient Rehabilitation After Pediatric Traumatic Brain Injury: Population Characteristics and Prescribing Patterns.
Objective: To understand how methylphenidate (MPH) is used in youth with traumatic brain injury (TBI) during inpatient pediatric rehabilitation.
Setting: Inpatient pediatric rehabilitation.
Participants: In total, 234 children with TBI; 62 of whom received MPH and 172 who did not. Patients were on average 11.6 years of age (range, 2 months to 21 years); 88 of 234 were female; the most common mechanism of injury was motor vehicle collision (49%); median (IQR) acute hospital length of stay (LOS) and inpatient rehabilitation LOS were 16 (10-29) and 23 (14-39), respectively; 51 of 234 were in a disorder of consciousness cognitive state at time of inpatient rehabilitation admission.
Design: Multicenter, retrospective medical record review.
Main measures: Patient demographic data, time to inpatient pediatric rehabilitation admission (TTA), cognitive state, MPH dosing (mg/kg/day).
Results: Patients who received MPH were older (P = .011); TTA was significantly longer in patients who received MPH than those who did not (P =.002). The lowest recorded dose range by weight was 0.05 to 0.89 mg/kg/d, representing an 18-fold difference; the weight-based range for the maximum dose was 0.11 to 0.97 mg/kg/d, a 9-fold difference. Patients in lower cognitive states at admission (P = .001) and at discharge (P = .030) were more likely to receive MPH. Five patients had side effects known to be associated with MPH; no serious adverse events were reported.
Conclusion: This multicenter study indicates that there is variable use of MPH during acute inpatient rehabilitation for children with TBI. Children who receive MPH tend to be older with lower cognitive states. Dosing practices are likely consistent with underdosing. Clinical indications for MPH use during inpatient pediatric rehabilitation should be better defined. The use of MPH, as well as its combination with other medications and treatments, during inpatient rehabilitation needs to be further explored.
期刊介绍：
Language in Society is an international journal of sociolinguistics concerned with language and discourse as aspects of social life. The journal publishes empirical articles of general theoretical, comparative or methodological interest to students and scholars in sociolinguistics, linguistic anthropology, and related fields. Language in Society aims to strengthen international scholarship and interdisciplinary conversation and cooperation among researchers interested in language and society by publishing work of high quality which speaks to a wide audience. In addition to original articles, the journal publishes reviews and notices of the latest important books in the field as well as occasional theme and discussion sections.
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