小儿创伤性脑损伤与长期使用抗抑郁药：一项基于全国登记处的队列研究。

Paediatric Traumatic Brain Injury and Long-Term Antidepressant Use: A Nationwide Register-Based Cohort Study.

作者信息

Laaksonen Juho, Ponkilainen Ville, Möttönen Julius, Mattila Ville M, Kuitunen Ilari

机构信息

Tampereen yliopisto Laaketieteen ja terveysteknologian tiedekunta, Tampere, Pirkanmaa, Finland.

Tays Tuki-ja liikuntaelinkeskuksen osasto, Tampere, Pirkanmaa, Finland.

出版信息

Acta Paediatr. 2025 Jun 2. doi: 10.1111/apa.70158.

DOI:10.1111/apa.70158

PMID:40457730

Abstract

AIM

The association between paediatric traumatic brain injury (pTBI) and post-traumatic antidepressant medication usage remains an understudied subject.

METHODS

A nationwide Finnish retrospective cohort study (1998-2018) included 71 969 pTBI patients and 64 856 orthopaedic references. Antidepressant medication data were sourced from the Finnish Social Insurance Institution. The primary outcome was post-traumatic paediatric antidepressant use.

RESULTS

The study included 136 825 patients. Kaplan-Meier analyses showed higher antidepressant use in pTBI patients, especially after 5 years and following surgery. The cumulative incidence rate (CIR) after 1 year was 0.73% (pTBI) versus 0.34% (references), increasing to 26.95% versus 25.51% after 20 years. Cox regression showed a higher long-term risk in pTBI patients (HR 1.31, up to 9 years). Operatively treated pTBI had an HR of 4.45 after 2 years. Among females, HR was 2.60 after 1 year, while in males, HR was 1.54.

CONCLUSIONS

The risk of antidepressant use following pTBI is notably higher after the first year, for both sexes and among patients who undergo operative treatment for pTBI. This elevated risk persists for 9 years but then declines.

摘要

目的

小儿创伤性脑损伤（pTBI）与创伤后抗抑郁药物使用之间的关联仍是一个研究不足的课题。

方法

一项芬兰全国性回顾性队列研究（1998 - 2018年）纳入了71969例pTBI患者和64856例骨科对照。抗抑郁药物数据来自芬兰社会保险机构。主要结局是创伤后小儿抗抑郁药物的使用情况。

结果

该研究纳入了136825例患者。Kaplan - Meier分析显示，pTBI患者的抗抑郁药物使用率较高，尤其是在5年后和手术后。1年后的累积发病率（CIR）为0.73%（pTBI组）对0.34%（对照组），20年后增至26.95%对25.51%。Cox回归显示pTBI患者的长期风险较高（风险比[HR]为1.31，长达9年）。接受手术治疗的pTBI患者在2年后的HR为4.45。在女性中，1年后的HR为2.60，而在男性中，HR为1.54。