Inpatient statin use predicts improved ischemic stroke discharge disposition.
Neurology
; 78(21): 1678-83, 2012 May 22.
Article
en En
| MEDLINE
| ID: mdl-22614435
ABSTRACT
OBJECTIVE:
To determine whether statin use is associated with improved discharge disposition after ischemic stroke.METHODS:
We used generalized ordinal logistic regression to analyze discharge disposition among 12,689 patients with ischemic stroke over a 7-year period at 17 hospitals in an integrated care delivery system. We also analyzed treatment patterns by hospital to control for the possibility of confounding at the individual patient level.RESULTS:
Statin users before and during stroke hospitalization were more likely to have a good discharge outcome (odds ratio [OR] for discharge to home = 1.38, 95% confidence interval [CI] 1.25-1.52, p < 0.001; OR for discharge to home or institution = 2.08, 95% CI 1.72-2.51, p < 0.001). Patients who underwent statin withdrawal were less likely to have a good discharge outcome (OR for discharge to home = 0.77, 95% CI 0.63-0.94, p = 0.012; OR for discharge to home or institution = 0.43, 95% CI 0.33-0.55, p < 0.001). In grouped-treatment analysis, an instrumental variable method using treatment patterns by hospital, higher probability of inpatient statin use predicted a higher likelihood of discharge to home (OR = 2.56, 95% CI 1.71-3.85, p < 0.001). In last prior treatment analysis, a novel instrumental variable method, patients with a higher probability of statin use were more likely to have a good discharge outcome (OR for each better level of ordinal discharge outcome = 1.19, 95% CI 1.09-1.30, p = 0.001).CONCLUSIONS:
Statin use is strongly associated with improved discharge disposition after ischemic stroke.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Alta del Paciente
/
Isquemia Encefálica
/
Inhibidores de Hidroximetilglutaril-CoA Reductasas
/
Accidente Cerebrovascular
/
Pacientes Internos
Tipo de estudio:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
/
Aged80
/
Humans
/
Middle aged
Idioma:
En
Revista:
Neurology
Año:
2012
Tipo del documento:
Article
País de afiliación:
Estados Unidos