Noaman Samer, Al-Mukhtar Omar, Abramovic Sheri, Mohammed Hanin, Goh Cheng Yee, Long Claire, Neil Christopher, Janus Edward, Cox Nicholas, Chan William
Cardiology Unit, Western Health, Melbourne, Vic, Australia; Department of Cardiovascular Medicine, Alfred Hospital, Melbourne, Vic, Australia; Ballarat Health Services, Ballarat, Vic, Australia.
Cardiology Unit, Western Health, Melbourne, Vic, Australia.
Heart Lung Circ. 2019 Mar;28(3):423-429. doi: 10.1016/j.hlc.2017.12.009. Epub 2018 Jan 31.
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.
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.
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.
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.
评估影响入住亚急性老年病房的老年人群停用他汀类药物决策的人口统计学和临床因素。本研究的目的是评估影响老年人停用他汀类药物决策过程的临床因素。
我们通过回顾2012年2月4日至2013年2月4日（含）这12个月期间西部健康 - 威廉斯敦医院的医院数字病历，对从老年评估与管理病房出院的患者（≥60岁）中他汀类药物停用和处方的变化进行了回顾性评估。该研究的主要结果是使用逻辑回归分析确定他汀类药物停用的独立预测因素。
在研究人群中，46%在入院前已被处方他汀类药物。出院时17.5%的患者停用了他汀类药物。他汀类药物停用的预测因素包括八旬老人状态、一级预防指征、功能恢复不佳、入住养老院的出院目的地和较低的认知功能。既往心血管疾病史和合并症负担不是他汀类药物停用的预测因素。
我们观察到，预后较差的因素，如高龄、功能恢复不佳、认知功能较差、出院后入住养老院以及他汀类药物处方的一级预防指征，是老年病房中他汀类药物停用的预测因素。
