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


METHODS
Observational cohort study of post-stroke rehabilitation.


METHODS
Six inpatient rehabilitation hospitals in the United States.


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


METHODS
Not applicable.


METHODS
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.
Conroy
Brendan
B
Stroke Recovery Program, National Rehabilitation Hospital, Washington, DC, USA.
Zorowitz
Richard
R
Horn
Susan D
SD
Ryser
David K
DK
Teraoka
Jeff
J
Smout
Randall J
RJ
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000978:Antiparkinson Agents / Q000009:adverse effects / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D002491:Central Nervous System Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012047:Rehabilitation Centers; D012720:Severity of Illness Index; D020521:Stroke / Q000188:drug therapy; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome
D000978:Antiparkinson Agents; D014150:Antipsychotic Agents; D002491:Central Nervous System Agents