(1597) Antiepileptic Drug Practices in the Adult Trauma Setting: A Multicenter Survey Study

Introduction: Antiepileptic drug (AED) use in traumatic brain injuries (TBIs) reduces the risk of early post-traumatic seizure (PTS). Agent selection, dosing, and length of therapy remains inconsistent among trauma centers in the United States. The purpose of this study was to identify and characterize the most common PTS prophylaxis practices among adult trauma centers in brain injured patients throughout the United States.

Methods: A survey assessing PTS prophylaxis practice of trauma centers was created and distributed in March 2023. Data was then grouped based on practice site demographics and sub-group analyses were performed.

Results: Of the 84 included survey responses, 82 (97.6%) respondents reported levetiracetam as their site’s drug of choice for PTS prophylaxis. Of these reporting levetiracetam use, the most often reported loading dose utilized was 1000 mg (n = 24, 46.2%) and the most often reported maintenance dose utilized was 500 mg BID (n = 39, 48.8%). There were no statistically significant differences in practice when sub-group analyses of survey respondent demographics were performed.

Conclusions: This multicenter, survey study, identified vast variances in practice for PTS prophylaxis for brain injured patients with a lack of statistical difference found in practice when analyzed by demographics. Further studies should evaluate optimal agent, dosing schemes, and duration in this cohort.