Samer Noaman1, Omar Al-Mukhtar2, Sheri Abramovic2, Hanin Mohammed3, Cheng Yee Goh2, Claire Long4, Christopher Neil5, Edward Janus6, Nicholas Cox5, William Chan7. 1. Cardiology Unit, Western Health, Melbourne, Vic, Australia; Department of Cardiovascular Medicine, Alfred Hospital, Melbourne, Vic, Australia; Ballarat Health Services, Ballarat, Vic, Australia. 2. Cardiology Unit, Western Health, Melbourne, Vic, Australia. 3. Ballarat Health Services, Ballarat, Vic, Australia. 4. The Geriatric Medicine Unit, Western Health, Melbourne, Vic, Australia. 5. Cardiology Unit, Western Health, Melbourne, Vic, Australia; Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, Vic, Australia. 6. General Internal Medicine Unit, Western Health, Melbourne, Vic, Australia; Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, Vic, Australia. 7. Cardiology Unit, Western Health, Melbourne, Vic, Australia; Department of Cardiovascular Medicine, Alfred Hospital, Melbourne, Vic, Australia; Monash University, Melbourne, Vic, Australia; Melbourne Medical School, Faculty of Medicine, Dentistry, and Health Sciences, The University of Melbourne, Melbourne, Vic, Australia; Baker Heart and Diabetes Institute, Melbourne, Vic, Australia. Electronic address: William.chan@unimelb.edu.au.
Abstract
BACKGROUND: Assessment of demographic and clinical factors influencing the decision of statin discontinuation in the elderly population admitted to subacute geriatric unit. The aim of this study is to assess the clinical factors impacting the decision-making process of statin discontinuation in the elderly. METHODS: We retrospectively assessed changes in statin discontinuation and prescription among patients (≥60 years old) discharged from a geriatric evaluation and management unit by reviewing hospital digital medical records at Western Health - The Williamstown Hospital over a 12-month period from 4 February 2012 until 4 February 2013 inclusive. The main outcome of the study was to determine the independent predictors of statin discontinuation using logistic regression analysis. RESULTS: Of the studied population, 46% were already prescribed statins prior to their admission. Statins were discontinued in 17.5% of patients at discharge. Predictors of statin de-prescription included octogenarian status, primary prevention indication, poor functional recovery, residential care facility discharge destination and lower cognitive function. The presence of previous cardiovascular disease history and the burden of comorbidities were not predictors of statin discontinuation. CONCLUSIONS: We observed that factors that conveyed poor prognosis such as advanced age, poor functional recovery, worse cognitive function, being discharged to a residential care facility as well as primary prevention indication for statin prescription are predictors of statin discontinuation in the geriatric unit.
BACKGROUND: Assessment of demographic and clinical factors influencing the decision of statin discontinuation in the elderly population admitted to subacute geriatric unit. The aim of this study is to assess the clinical factors impacting the decision-making process of statin discontinuation in the elderly. METHODS: We retrospectively assessed changes in statin discontinuation and prescription among patients (≥60 years old) discharged from a geriatric evaluation and management unit by reviewing hospital digital medical records at Western Health - The Williamstown Hospital over a 12-month period from 4 February 2012 until 4 February 2013 inclusive. The main outcome of the study was to determine the independent predictors of statin discontinuation using logistic regression analysis. RESULTS: Of the studied population, 46% were already prescribed statins prior to their admission. Statins were discontinued in 17.5% of patients at discharge. Predictors of statin de-prescription included octogenarian status, primary prevention indication, poor functional recovery, residential care facility discharge destination and lower cognitive function. The presence of previous cardiovascular disease history and the burden of comorbidities were not predictors of statin discontinuation. CONCLUSIONS: We observed that factors that conveyed poor prognosis such as advanced age, poor functional recovery, worse cognitive function, being discharged to a residential care facility as well as primary prevention indication for statin prescription are predictors of statin discontinuation in the geriatric unit.