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.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  In this nonrandomized comparison, treatment with benzodiazepines as a concomitant medication had no independent impact on stroke outcome.
authors.affiliation: Department of Medicine and Therapeutics, Faculty of Medicine, University of Glasgow, Glasgow, UK; Department of Neurology, University of Duisburg-Essen, Essen, Germany.
authors.forename: Benedikt
authors.initials: B
authors.lastname: Frank
authors.forename: Rachael L
authors.initials: RL
authors.lastname: Fulton
authors.forename: Kennedy R
authors.initials: KR
authors.lastname: Lees
authors.forename: Robert D
authors.initials: RD
authors.lastname: Sanders
mesh_terms: D000368:Aged; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use*; D002545:Brain Ischemia / Q000150:complications* / Q000628:therapy; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D011014:Pneumonia / Q000150:complications* / Q000453:epidemiology*; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications* / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D001569:Benzodiazepines
keywords: benzodiazepine; mortality; outcome; pneumonia; stroke