Impact of benzodiazepines on functional outcome and occurrence of pneumonia in stroke: Evidence from VISTA

Benedikt Frank; Rachael L. Fulton; Kennedy R. Lees; Robert D. Sanders; A. Alexandrov; P. W. Bath; E. Bluhmki; N. Bornstein; L. Claesson; J. Curram; S. M. Davis; G. Donnan; H. C. Diener; M. Fisher; B. Gregson; J. Grotta; W. Hacke; M. G. Hennerici; M. Hommel; M. Kaste; P. Lyden; J. Marler; K. Muir; R. Sacco; A. Shuaib; P. Teal; N. G. Wahlgren; S. Warach; C. Weimar

doi:10.1111/ijs.12148

Impact of benzodiazepines on functional outcome and occurrence of pneumonia in stroke: Evidence from VISTA

Benedikt Frank, Rachael L. Fulton, Kennedy R. Lees, Robert D. Sanders, A. Alexandrov, P. W. Bath, E. Bluhmki, N. Bornstein, L. Claesson, J. Curram, S. M. Davis, G. Donnan, H. C. Diener, M. Fisher, B. Gregson, J. Grotta, W. Hacke, M. G. Hennerici, M. Hommel, M. KasteP. Lyden, J. Marler, K. Muir, R. Sacco, A. Shuaib, P. Teal, N. G. Wahlgren, S. Warach, C. Weimar

Neurology & Neurotherapeutics

Research output: Contribution to journal › Article › peer-review

7 Scopus citations

Abstract

Background: Benzodiazepines have been proposed both as a neuroprotectant and risk factor for pneumonia in acute stroke. Aims: We assessed the impact of benzodiazepine exposure on the modified Rankin scale score distribution at 90 days as well as pneumonia rates among patients registered in a trials archive. Method: We used an age, baseline National Institutes of Health Stroke Score, and thrombolysis-rate adjusted Cochran-Mantel-Haenszel test to test significance (P) followed by proportional odds logistic regression analysis to estimate the odds ratios for improved modified Rankin scale score, and binary logistic regression to estimate the odds ratio for developing pneumonia. Results: Data were available for 5938 patients, of whom 1800 received benzodiazepines. No association of benzodiazepine use and overall stroke outcome could be found (odds ratio 0·90, 95% confidence interval 0·82-1·00, P=0·121). Pneumonia occurred in 12·8% of patients treated with benzodiazepines and in 13·6% of the controls (odds ratio 0·99, 95% confidence interval 0·83-1·18, P=0·904). Conclusion: In this nonrandomized comparison, treatment with benzodiazepines as a concomitant medication had no independent impact on stroke outcome.

Original language	English (US)
Pages (from-to)	890-894
Number of pages	5
Journal	International Journal of Stroke
Volume	9
Issue number	7
DOIs	https://doi.org/10.1111/ijs.12148
State	Published - Oct 1 2014

Keywords

Benzodiazepine
Mortality
Outcome
Pneumonia
Stroke

ASJC Scopus subject areas

Neurology

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10.1111/ijs.12148

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Frank, B., Fulton, R. L., Lees, K. R., Sanders, R. D., Alexandrov, A., Bath, P. W., Bluhmki, E., Bornstein, N., Claesson, L., Curram, J., Davis, S. M., Donnan, G., Diener, H. C., Fisher, M., Gregson, B., Grotta, J., Hacke, W., Hennerici, M. G., Hommel, M., ... Weimar, C. (2014). Impact of benzodiazepines on functional outcome and occurrence of pneumonia in stroke: Evidence from VISTA. International Journal of Stroke, 9(7), 890-894. https://doi.org/10.1111/ijs.12148

Frank, B, Fulton, RL, Lees, KR, Sanders, RD, Alexandrov, A, Bath, PW, Bluhmki, E, Bornstein, N, Claesson, L, Curram, J, Davis, SM, Donnan, G, Diener, HC, Fisher, M, Gregson, B, Grotta, J, Hacke, W, Hennerici, MG, Hommel, M, Kaste, M, Lyden, P, Marler, J, Muir, K, Sacco, R, Shuaib, A, Teal, P, Wahlgren, NG, Warach, S & Weimar, C 2014, 'Impact of benzodiazepines on functional outcome and occurrence of pneumonia in stroke: Evidence from VISTA', International Journal of Stroke, vol. 9, no. 7, pp. 890-894. https://doi.org/10.1111/ijs.12148

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title = "Impact of benzodiazepines on functional outcome and occurrence of pneumonia in stroke: Evidence from VISTA",

abstract = "Background: Benzodiazepines have been proposed both as a neuroprotectant and risk factor for pneumonia in acute stroke. Aims: We assessed the impact of benzodiazepine exposure on the modified Rankin scale score distribution at 90 days as well as pneumonia rates among patients registered in a trials archive. Method: We used an age, baseline National Institutes of Health Stroke Score, and thrombolysis-rate adjusted Cochran-Mantel-Haenszel test to test significance (P) followed by proportional odds logistic regression analysis to estimate the odds ratios for improved modified Rankin scale score, and binary logistic regression to estimate the odds ratio for developing pneumonia. Results: Data were available for 5938 patients, of whom 1800 received benzodiazepines. No association of benzodiazepine use and overall stroke outcome could be found (odds ratio 0·90, 95% confidence interval 0·82-1·00, P=0·121). Pneumonia occurred in 12·8% of patients treated with benzodiazepines and in 13·6% of the controls (odds ratio 0·99, 95% confidence interval 0·83-1·18, P=0·904). Conclusion: In this nonrandomized comparison, treatment with benzodiazepines as a concomitant medication had no independent impact on stroke outcome.",

keywords = "Benzodiazepine, Mortality, Outcome, Pneumonia, Stroke",

author = "Benedikt Frank and Fulton, {Rachael L.} and Lees, {Kennedy R.} and Sanders, {Robert D.} and A. Alexandrov and Bath, {P. W.} and E. Bluhmki and N. Bornstein and L. Claesson and J. Curram and Davis, {S. M.} and G. Donnan and Diener, {H. C.} and M. Fisher and B. Gregson and J. Grotta and W. Hacke and Hennerici, {M. G.} and M. Hommel and M. Kaste and P. Lyden and J. Marler and K. Muir and R. Sacco and A. Shuaib and P. Teal and Wahlgren, {N. G.} and S. Warach and C. Weimar",

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doi = "10.1111/ijs.12148",

language = "English (US)",

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T1 - Impact of benzodiazepines on functional outcome and occurrence of pneumonia in stroke

T2 - Evidence from VISTA

AU - Frank, Benedikt

AU - Fulton, Rachael L.

AU - Lees, Kennedy R.

AU - Sanders, Robert D.

AU - Alexandrov, A.

AU - Bath, P. W.

AU - Bluhmki, E.

AU - Bornstein, N.

AU - Claesson, L.

AU - Curram, J.

AU - Davis, S. M.

AU - Donnan, G.

AU - Diener, H. C.

AU - Fisher, M.

AU - Gregson, B.

AU - Grotta, J.

AU - Hacke, W.

AU - Hennerici, M. G.

AU - Hommel, M.

AU - Kaste, M.

AU - Lyden, P.

AU - Marler, J.

AU - Muir, K.

AU - Sacco, R.

AU - Shuaib, A.

AU - Teal, P.

AU - Wahlgren, N. G.

AU - Warach, S.

AU - Weimar, C.

PY - 2014/10/1

Y1 - 2014/10/1

N2 - Background: Benzodiazepines have been proposed both as a neuroprotectant and risk factor for pneumonia in acute stroke. Aims: We assessed the impact of benzodiazepine exposure on the modified Rankin scale score distribution at 90 days as well as pneumonia rates among patients registered in a trials archive. Method: We used an age, baseline National Institutes of Health Stroke Score, and thrombolysis-rate adjusted Cochran-Mantel-Haenszel test to test significance (P) followed by proportional odds logistic regression analysis to estimate the odds ratios for improved modified Rankin scale score, and binary logistic regression to estimate the odds ratio for developing pneumonia. Results: Data were available for 5938 patients, of whom 1800 received benzodiazepines. No association of benzodiazepine use and overall stroke outcome could be found (odds ratio 0·90, 95% confidence interval 0·82-1·00, P=0·121). Pneumonia occurred in 12·8% of patients treated with benzodiazepines and in 13·6% of the controls (odds ratio 0·99, 95% confidence interval 0·83-1·18, P=0·904). Conclusion: In this nonrandomized comparison, treatment with benzodiazepines as a concomitant medication had no independent impact on stroke outcome.

AB - Background: Benzodiazepines have been proposed both as a neuroprotectant and risk factor for pneumonia in acute stroke. Aims: We assessed the impact of benzodiazepine exposure on the modified Rankin scale score distribution at 90 days as well as pneumonia rates among patients registered in a trials archive. Method: We used an age, baseline National Institutes of Health Stroke Score, and thrombolysis-rate adjusted Cochran-Mantel-Haenszel test to test significance (P) followed by proportional odds logistic regression analysis to estimate the odds ratios for improved modified Rankin scale score, and binary logistic regression to estimate the odds ratio for developing pneumonia. Results: Data were available for 5938 patients, of whom 1800 received benzodiazepines. No association of benzodiazepine use and overall stroke outcome could be found (odds ratio 0·90, 95% confidence interval 0·82-1·00, P=0·121). Pneumonia occurred in 12·8% of patients treated with benzodiazepines and in 13·6% of the controls (odds ratio 0·99, 95% confidence interval 0·83-1·18, P=0·904). Conclusion: In this nonrandomized comparison, treatment with benzodiazepines as a concomitant medication had no independent impact on stroke outcome.

KW - Benzodiazepine

KW - Mortality

KW - Outcome

KW - Pneumonia

KW - Stroke

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Impact of benzodiazepines on functional outcome and occurrence of pneumonia in stroke: Evidence from VISTA

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