Evidence map›Paper›PMID 41379762›Full record

ArticleNeuroepidemiology2025

Botulinum Toxin Underuse in Older Stroke Survivors with Spasticity: A Nationwide Population-Based Cohort Study.

Etienne Ojardias, Jonathan Levy, Lorène Zerah, Pierre Karam, Anne Forestier, Jean-Yves Loze, Djamel Bensmail, Rebecca Haddad

Abstract read
In one paragraph

Article in Neuroepidemiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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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

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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

8 authors.

Etienne OjardiasPhysical Medicine and Rehabilitation Department, University Hospital of Saint-Etienne, Saint-Etienne, France, etienne.ojardias@chu-st-etienne.fr.
Jonathan LevyDepartment of Physical and Rehabilitation Medicine, Raymond-Poincaré Teaching Hospital, AP-HP, Université Paris-Saclay, Garches, France.
Lorène ZerahDepartment of Geriatric Medicine, Pitié-Salpêtrière University Hospital, AP-HP, Paris, France.
Pierre KaramPKCS, Ecully, France.
Anne ForestierIpsen, Paris, France.
Jean-Yves LozeIpsen, Paris, France.
Djamel BensmailDepartment of Physical and Rehabilitation Medicine, Raymond-Poincaré Teaching Hospital, AP-HP, Université Paris-Saclay, Garches, France.
Rebecca HaddadDepartment of Neurorehabilitation, Rothschild Hospital, Paris, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionWhile botulinum toxin type A (BoNT-A) is effective for poststroke spasticity, its accessibility in older adults remains unclear. We aimed to examine the association between BoNT-A use and age among stroke survivors.

methodsThis nationwide, population-based, retrospective cohort study analyzed data from the French National Hospital Discharge Database. Stroke survivors admitted between 2014 and 2016 were followed until 2020. BoNT-A use was assessed across different age groups (18-64, 65-74, 75-84, ≥85 years). Multivariable logistic regression was performed to examine the association between BoNT-A use and age, adjusting for potential confounders, including sex, comorbidities, stroke unit hospitalization, and rehabilitation.

resultsBoNT-A use was reported in 1,757 (2.88%), 862 (0.99%), and 183 (0.22%) of 60,928, 86,917, and 82,725 stroke survivors aged 65-74, 75-84, and ≥85 years, respectively. These rates were significantly lower than BoNT-A use in those aged <65 years (5.13%) (p < 0.001). After adjustment, the inverse relationship between age and BoNT-A use was maintained, demonstrating an age-dependent association in the 65-74, 75-84, and ≥85 age groups vs. 18-64 years. Odds ratios (ORs) (95% confidence intervals [CIs]) were 0.49 (0.47-0.53), 0.18 (0.17-0.19), and 0.05 (0.04-0.06), respectively. Stroke unit stays (OR, 1.33; 95% CI, 1.26-1.41) and neurological rehabilitation unit stays (OR, 16.69; 95% CI, 15.59-17.87) were significantly associated with a higher probability of receiving BoNT-A.

conclusionsBoNT-A use is notably low in older stroke survivors, highlighting the need to enhance equitable access to BoNT-A injections for this population.

Indexed as

AgeBotulinum toxinHealth equityOlder adultsSpasticityStroke

Identifiers

PMID41379762
PMCPMC12795544

What Socratic holds

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LicenceCC BY-NC
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Registered trials

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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 Socratic graph.