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Codeine is associated with poor prognosis in acute stroke.

Stian T Ryste1, Bernt A Engelsen2,3, Halvor Naess2,3,4

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Codeine-containing analgesics negatively impact stroke recovery, increasing pneumonia and stroke worsening. Other pain relievers, sedatives, and sleeping drugs showed no adverse effects in acute stroke patients.

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Area of Science:

  • Neurology
  • Pharmacology

Background:

  • Investigating medication use in acute stroke care.
  • Examining analgesics, sleeping drugs, and sedatives.
  • Focus on prognosis and complications within 48 hours post-stroke.

Purpose of the Study:

  • To determine the relationship between analgesics, sleeping drugs, and sedatives and stroke outcomes.
  • To assess the impact of these medications on prognosis and complications in the acute phase.

Main Methods:

  • Retrospective analysis of 921 patient records from the Bergen NORSTROKE registry (2009-2012).
  • Inclusion of patients with ischemic stroke, hemorrhagic stroke, and transient ischemic attack.
  • Data collection on medication use (analgesics, sleeping drugs, sedatives) within 48 hours of admission.

Main Results:

  • Codeine-containing analgesics were linked to increased pneumonia (OR=3.8), stroke worsening (OR=2.7), and higher modified Rankin Scale scores at day 7 (OR=2).
  • No significant association was found between other analgesics, sedatives, or sleeping drugs and poorer prognosis or increased complications.
  • Study included 921 patients (408 female, 513 male) with a mean age of 71.0 years.

Conclusions:

  • Codeine-containing analgesics are associated with poorer short-term prognosis and increased complications in acute stroke patients.
  • Findings suggest a potential negative effect of codeine on acute stroke outcomes.
  • Further prospective studies are needed to confirm these associations and understand underlying mechanisms.