Evidence map›Paper›PMID 40144887›Full record

ArticleNeurology. Clinical practice2025

Benzodiazepine Initiation and the Risk of Falls or Fall-Related Injuries in Older Adults Following Acute Ischemic Stroke.

Shuo Sun, Victor Lomachinsky, Louisa H Smith, Joseph P Newhouse, M Brandon Westover, Deborah Lynne Blacker, Lee H Schwamm, Sebastien Haneuse, Lidia M V R Moura

Abstract read
In one paragraph

Article in Neurology. Clinical practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Shuo SunDepartment of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA.ORCID https://orcid.org/0000-0002-4170-9388
Victor LomachinskyDepartment of Neurology, Massachusetts General Hospital, Boston.ORCID https://orcid.org/0000-0002-2306-6673
Louisa H SmithDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.ORCID https://orcid.org/0000-0001-9029-4644
Joseph P NewhouseDepartment of Health Care Policy, Harvard Medical School, Boston, MA.ORCID https://orcid.org/0000-0001-5837-3203
M Brandon WestoverDepartment of Neurology, Beth Israel Lahey Health Medical System, Boston, MA.ORCID https://orcid.org/0000-0003-4803-312X
Deborah Lynne BlackerDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.ORCID https://orcid.org/0000-0001-6107-7376
Lee H SchwammDigital Strategy and Transformation, Office of the Dean, Yale School of Medicine, New Haven, CT; and.ORCID https://orcid.org/0000-0003-0592-9145
Sebastien HaneuseDepartment of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA.ORCID https://orcid.org/0000-0003-4963-0655
Lidia M V R MouraDepartment of Neurology, Massachusetts General Hospital, Boston.ORCID https://orcid.org/0000-0002-1191-1315

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background and Objectives: Benzodiazepine (BZD) use in older adults after acute ischemic stroke (AIS) is common. We aimed to assess the risk of falls or fall-related injuries (FRIs) in older adults after the use of BZDs during the acute poststroke recovery period. Methods: We emulated a hypothetical randomized trial of BZD use during the acute poststroke recovery period using linked data from the Get With the Guidelines Stroke Registry and Mass General Brigham's electronic health records. Our cohort included patients aged 65 years and older with an AIS admission between 2014 and 2021, no documented previous stroke, and no BZD prescriptions in the 3 months before admission. The potential for immortal time and confounding bias was addressed separately using inverse probability weighting. Results: We analyzed data from 495 patients who initiated inpatient BZDs within 3 days of admission and 2,564 who did not. After standardization, the estimate was 694 events per 1,000 (95% CI 676-709) for the BZD initiation strategy and 584 events per 1,000 (95% CI 575-595) for the noninitiation strategy. Subgroup analyses showed risk differences of 142 events per 1,000 (95% CI 111-165) and 85 events per 1,000 (95% CI 64-107) for patients aged 65-74 years and 75 years and older, respectively. Risk differences were 187 events per 1,000 (95% CI 159-206) for patients with minor (NIH Stroke Severity Scale score Discussion: Initiating BZDs within 3 days of an AIS is associated with an elevated ten-day risk of falls or FRIs, particularly for patients aged 65-74 years and for those with mild stroke. This underscores the need for caution when initiating BZDs, especially among individuals likely to be ambulatory during the acute and subacute poststroke period.

Identifiers

PMID40144887
PMCPMC11936338

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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.