Evidence map›Paper›PMID 36572369›Full record

ArticleJournal of clinical epidemiology2023

No short-term mortality from benzodiazepine use post-acute ischemic stroke after accounting for bias.

Lidia M V R Moura, Zhiyu Yan, Maria A Donahue, Louisa H Smith, Lee H Schwamm, John Hsu, Joseph P Newhouse, Sebastien Haneuse, Deborah Blacker, Sonia Hernandez-Diaz

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of clinical epidemiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.6field-weighted citation impact, top 33% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 5 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Lidia M V R MouraDepartment of Neurology, Massachusetts General Hospital, Boston, MA, USA; Department of Neurology, Harvard Medical School, Boston, MA, USA. Electronic address: lidia.moura@mgh.harvard.edu.
Zhiyu YanDepartment of Neurology, Massachusetts General Hospital, Boston, MA, USA.
Maria A DonahueDepartment of Neurology, Massachusetts General Hospital, Boston, MA, USA.
Louisa H SmithDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Lee H SchwammDepartment of Neurology, Massachusetts General Hospital, Boston, MA, USA; Department of Neurology, Harvard Medical School, Boston, MA, USA.
John HsuDepartment of Health Care Policy, Harvard Medical School, Boston, MA, USA; Mongan Institute, Massachusetts General Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA.
Joseph P NewhouseDepartment of Health Care Policy, Harvard Medical School, Boston, MA, USA; National Bureau of Economic Research, Cambridge, MA, USA; Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Harvard Kennedy School, Cambridge, MA, USA.
Sebastien HaneuseDepartment of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Deborah BlackerDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
Sonia Hernandez-DiazDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Massachusetts General Hospital · USHarvard University · USNational Bureau of Economic Research · US

Funding

Alzheimer's Disease Genetics ConsortiumU01AG032984 · NIA · UNIVERSITY OF PENNSYLVANIA · PI SCHELLENBERG, GERARD DAVID · 2009 to 2024
$60.4M
Vascular factors, physical activity, and inflammation as modulators of neurodegenerative and cognitive trajectories (Project 2)P01AG036694 · NIA · MASSACHUSETTS GENERAL HOSPITAL · PI REISA A. SPERLING · 2010 to 2026
$50.2M
Main Administrative CoreU19AG062682 · NIA · HENNEPIN HEALTHCARE RESEARCH INSTITUTE · PI WOODS, ROBYN LORRAINE · 2019 to 2023
$42.9M
Tradeoffs in the Design of Public Long-Term Care BenefitsP01AG032952 · NIA · HARVARD MEDICAL SCHOOL · PI Bruce E. Landon · 2009 to 2026
$39.0M
Research Education ComponentP30AG062421 · NIA · MASSACHUSETTS GENERAL HOSPITAL · PI STEVEN E ARNOLD · 2019 to 2026
$36.5M
VCID Biomarkers Coordinating CenterU24NS100591 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI Steven M Greenberg · 2016 to 2026
$19.8M
The Implementation Science Center for Cancer Control Equity - Research ProgramP50CA244433 · NCI · HARVARD SCHOOL OF PUBLIC HEALTH · PI EMMONS, KAREN M., TAVERAS BENAVIDEZ, ELSIE MIREYA · 2019 to 2023
$12.5M
Training Program in Psychiatric Genetics and Translational ResearchT32MH017119 · NIMH · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI KARESTAN C KOENEN, Jukka-Pekka Onnela · 1985 to 2026
$8.9M
Harnessing Diverse Bioinformatic Approaches To Repurpose Drugs For Alzheimers Disease And Related DementiasR01AG058063 · NIA · MASSACHUSETTS GENERAL HOSPITAL · PI MARK W ALBERS, PETER Karl SORGER · 2018 to 2026
$7.8M
COVID-19 and Acute Medical Care: Impact on Dementia PatientsR01AG062282 · NIA · MASSACHUSETTS GENERAL HOSPITAL · PI HSU, JOHN · 2018 to 2022
$4.5M
National Cohort Studies of Alzheimer's Disease, Related Dementias and Air PollutionR01AG066793 · NIA · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI ZANOBETTI, ANTONELLA · 2020 to 2025
$4.2M
Comparative Safety of Seizure Prophylaxis within the Medicare ProgramR01AG073410 · NIA · MASSACHUSETTS GENERAL HOSPITAL · PI Lidia Maria Veras Rocha de Moura · 2021 to 2026
$4.1M
ACL HHS U48DP006377NCCDPHP CDC HHS U48 DP006377NCI NIH HHS P50 CA244433NIA NIH HHS K08 AG053380NIA NIH HHS P01 AG032952NIA NIH HHS P01 AG036694NIA NIH HHS P30 AG062421NIA NIH HHS R01 AG048351NIA NIH HHS R01 AG058063NIA NIH HHS R01 AG062282NIA NIH HHS R01 AG063975NIA NIH HHS R01 AG066793NIA NIH HHS R01 AG073410NIA NIH HHS T32 AG051108NIA NIH HHS U01 AG032984NIA NIH HHS U01 AG068221NIA NIH HHS U01 AG076478NIA NIH HHS U19 AG062682NICHD NIH HHS R01 HD088393NICHD NIH HHS R01 HD098421NIDDK NIH HHS R01 DK107972NIDDK NIH HHS R01 DK128150NIMH NIH HHS T32 MH017119NINDS NIH HHS R01 NS104143NINDS NIH HHS U24 NS100591NINDS NIH HHS U24 NS107243
6 · The paper itself

Abstract

BACKGROUND AND

objectivesOlder adults receive benzodiazepines for agitation, anxiety, and insomnia after acute ischemic stroke (AIS). No trials have been conducted to determine if benzodiazepine use affects poststroke mortality in the elderly.

methodsWe examined the association between initiating benzodiazepines within 1 week after AIS and 30-day mortality. We included patients ≥65 years, admitted for new nonsevere AIS (NIH-Stroke-Severity[NIHSS]≤ 20), 2014-2020, with no recorded benzodiazepine use in the previous 3 months and no contraindication for use. We linked a stroke registry to electronic health records, used inverse-probability weighting to address confounding, and estimated the risk difference (RD). A process of cloning, weighting, and censoring was used to avoid immortal time bias.

resultsAmong 2,584 patients, 389 received benzodiazepines. The crude 30-day mortality risk from treatment initiation was 212/1,000 among patients who received benzodiazepines, while the 30-day mortality was 34/1,000 among those who did not. When follow-up was aligned on day of AIS admission and immortal time was assigned to the two groups, the estimated risks were 27/1,000 and 22/1,000, respectively. Upon further adjustment for confounders, the RD was 5 (-12 to 19) deaths/1,000 patients.

conclusionThe observed higher 30-day mortality associated with benzodiazepine initiation within 7 days was largely due to bias.

Indexed as

Brain IschemiaIschemic StrokeStrokeAgedBenzodiazepinesHumansBenzodiazepinesAcute ischemic strokeBenzodiazepinesMortalityNeurologyPolytherapyStroke

Identifiers

PMID36572369
PMCPMC10033385
OpenAlexW4312209905

What OpenQuestion holds

Textmetadata
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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.