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Titolo:
Effect of antiplatelet and anticoagulant agents on risk of hospitalizationfor bleeding among a population of elderly nursing home stroke survivors
Autore:
Quilliam, BJ; Lapane, KL; Eaton, CB; Mor, V;
Indirizzi:
Brown Univ, Ctr Gerontol & Healthcare Res, Providence, RI 02912 USA Brown Univ Providence RI USA 02912 althcare Res, Providence, RI 02912 USA Brown Univ, Dept Community Hlth, Providence, RI 02912 USA Brown Univ Providence RI USA 02912 mmunity Hlth, Providence, RI 02912 USA Brown Univ, Dept Family Med, Sch Med, Pawtucket, RI USA Brown Univ Pawtucket RI USA Dept Family Med, Sch Med, Pawtucket, RI USA
Titolo Testata:
STROKE
fascicolo: 10, volume: 32, anno: 2001,
pagine: 2299 - 2304
SICI:
0039-2499(200110)32:10<2299:EOAAAA>2.0.ZU;2-I
Fonte:
ISI
Lingua:
ENG
Soggetto:
MINIMUM DATA SET; GERIATRIC PHARMACOEPIDEMIOLOGY; RESIDENT ASSESSMENT; SAGE DATABASE; MDS; INSTRUMENT; OUTCOMES; WARFARIN; ASPIRIN; SCALE;
Keywords:
anticoagulants; antiplatelet agents; case-control studies; cerebellar hemorrhage; gastrointestinal hemorrhage; nursing homes; stroke;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
36
Recensione:
Indirizzi per estratti:
Indirizzo: Lapane, KL Brown Univ, Ctr Gerontol & Healthcare Res, Box G-B222, Providence, RI 02912 USA Brown Univ Box G-B222 Providence RI USA 02912 nce, RI 02912 USA
Citazione:
B.J. Quilliam et al., "Effect of antiplatelet and anticoagulant agents on risk of hospitalizationfor bleeding among a population of elderly nursing home stroke survivors", STROKE, 32(10), 2001, pp. 2299-2304

Abstract

Background and Purpose-Anticoagulants and antiplatelet agents are underutilized in the nursing home setting, perhaps because trials demonstrating treatment efficacy excluded people resembling those with long-term care needs. We sought to quantify the effect of antiplatelet and anticoagulant agents on risk of hospitalization for bleeding among an elderly nursing home population. Methods-We used a case-control design and identified first hospitalizations for bleeds using Medicare claims data from 1992 to 1997 as potential cases. Cases had at least one minimum data set (MDS) assessment within the 6 months before that hospitalization and a diagnosis of stroke. We identified up to 5 controls residing in the same facility during the same year and quarter as the case with a diagnosis of stroke. Our sample consisted of 3433 cases and 13 506 controls. Using the MDS, we identified standing orders for aspirin, dipyridamole, ticlopidine, or warfarin and used conditional logistic regression modeling to estimate the effect of these agents on risk of hospitalization for a bleed. Results-After adjustment, use of warfarin (odds ratio [OR], 1.26; 95% CI, 1.11 to 1.43) and combination therapy (OR, 1.34; 95% CI, 0.99 to 1.82) wereassociated with an increased risk of hospitalization for a bleed compared with nonusers. The odds of aspirin use was greater among cases than controls (OR, 1.07; 95% CI, 0.96 to 1.18) after adjustment. Conclusions-Although present, the risk associated with use of these agentsis small. The numbers needed to treat to harm 1 resident with aspirin and warfarin were 467 and 126, respectively.

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Documento generato il 22/01/20 alle ore 21:40:42