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22. European Stroke Conference Figure 1. Modified Rankin scale 3 months after ischemic stroke. 318 © 2013 S. Karger AG, Basel Scientific Programme 74 Stroke prognosis Initial stroke severity and early functional outcomes are not improved by prior SSRI prescrip-tion. P. Fearon1, D.J. Stott2, P. Langhorne3, T.J. Quinn4 Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UNITED KINGDOM1, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UNITED KINGDOM2, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UNITED KINGDOM3, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UNITED KINGDOM4 Background Improved functional recovery after stroke is associated with selective serotonin reuptake inhibitor (SSRI) prescription. The mechanism of action is unknown but direct modulation of spontaneous brain plasticity by SSRIs has been suggested. If SSRIs are neuroprotective, we hypothesized that prior SSRI prescription would be associated with a reduction in initial stroke severity and improved early functional outcomes. Methods We recorded clinical and demographic details of consecutive acute admissions with stroke or tran-sient ischaemic attack (TIA) from a geographically defined population (East Glasgow, UK) between February 2011 and March 2012. Outcomes of interest were: baseline stroke severity (National Insti-tute for Health Stroke Scale NIHSS), death in hospital, dependency at discharge (modified Rankin Scale mRS), length of stay (LOS) and home-time (censored at 90 days). We used Mann-Whitney U or Pearson’s Chi square where appropriate to compare outcomes between patients prescribed an SSRI prior to admission and those who were not; analyses were corrected for age and initial NIHSS. Results We recorded 312 acute presentations with stroke or TIA. Mean age 70.9 years (SD13.7); 55% male; median baseline NIHSS 3 (range 0-28). Anti-depressants were prescribed in 24% of patients pre-ad-mission and 14% were prescribed an SSRI. Median baseline NIHSS did not differ between SSRI and non-SSRI groups (3 (IQR:1-6) versus 3 (IQR:2-7); p=0.76). For patients with stroke (n=257), initial suggestion of greater mortality in the SSRI group (22% versus 10% (non-SSRI group); p=0.05) was not significant when corrected for age and baseline NIHSS (p=0.09). There was no be-tween group difference in dependency at discharge (p=0.25), LOS (p=0.50) or home-time (p=0.85). Conclusion We have not demonstrated early benefit of SSRIs in our modest sized dataset of unselected stroke patients. Future RCTs of SSRI in acute stroke should collect early and longer term functional out-come data.


Karger_ESC London_2013
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