An exploration of central nervous system medication use and outcomes in stroke rehabilitation.

Publication/Presentation Date

12-1-2005

Abstract

UNLABELLED: Conroy B, Zorowitz R, Horn SD, Ryser DK, Teraoka J, Smout RJ. An exploration of central nervous system medication use and outcomes in stroke rehabilitation.

OBJECTIVE: To study associations between neurobehavioral impairments, use of neurotropic medications, and outcomes for inpatient stroke rehabilitation, controlling for a variety of confounding variables.

DESIGN: Observational cohort study of post-stroke rehabilitation.

SETTING: Six inpatient rehabilitation hospitals in the United States.

PARTICIPANTS: Patients with moderate or severe strokes (N=919).

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Discharge disposition, FIM score change, and rehabilitation length of stay (LOS).

RESULTS: Neurobehavioral impairments and use of many medications, including first-generation selective serotonin reuptake inhibitors, older traditional antipsychotic medications, and anti-Parkinsonian neuro-stimulants, have a statistical association with poorer outcomes, whereas use of the atypical antipsychotic medications has a positive association with improvement in motor FIM scores. Counter-intuitively, use of opioid analgesics is associated with a larger motor FIM score change but not an increase in LOS or reduced percentage of discharge to community. There was significant variation in use of neurotropic medications among the 6 study sites during inpatient stroke rehabilitation.

CONCLUSIONS: There are many opportunities to enhance a stroke survivor's ability to benefit from acute inpatient stroke rehabilitation through improved understanding of associations of neurotropic medications with outcomes for different patient groups.

Volume

86

Issue

12 Suppl 2

First Page

73

Last Page

73

ISSN

0003-9993

Disciplines

Medicine and Health Sciences

PubMedID

16373142

Department(s)

Department of Medicine

Document Type

Article

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