TY - JOUR
T1 - Patterns and predictors of discharge statin prescription among hospitalized patients with intracerebral hemorrhage
AU - Ovbiagele, Bruce
AU - Schwamm, Lee H.
AU - Smith, Eric E.
AU - Hernandez, Adrian F.
AU - Olson, Daiwai M.
AU - Pan, Wenqin
AU - Fonarow, Gregg C.
AU - Saver, Jeffrey L.
PY - 2010/10
Y1 - 2010/10
N2 - Background And Purpose-: Many patients hospitalized with intracerebral hemorrhage are at high future risk for ischemic events and may benefit from stain therapy. However, little is known about patterns of statin prescription among patients with intracerebral hemorrhage, especially after the finding of higher hemorrhagic stroke risk in the statin treatment arm of the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial. We evaluated recent nationwide trends in discharge statin treatment after intracerebral hemorrhage hospitalization. Methods-: Using data from 25 673 patients with hemorrhagic stroke admitted to Get With Guidelines-Stroke participating hospitals between January 1, 2005, and December 31, 2007, we assessed factors associated with discharge statin prescription, including treatment over time and in relation to dissemination of the SPARCL Results. Piecewise logistic multivariable regression models were fit to track statin use in various periods. Results-: Mean age was 67.9±15 years, 48.1% female, and discharge statin treatment in 39.5%. Variables independently associated with lower discharge statin use included female sex (OR 0.87, 95% CI, 0.82 to 0.93), prior stroke/transient ischemic attack (OR 0.85, 95% CI, 0.78 to 0.92), academic center (OR 0.87, 95% CI, 0.82 to 0.93), and Midwest region (OR 0.65, 95% CI, 0.56 to 0.80). Statin prescription climbed over the study period from 66.9% to 74.5% (P<0.001) among eligible patients with a decrease during SPARCL reporting (P=0.03) and then a return to prior levels thereafter. Conclusions-: Discharge statin prescription among hospitalized patients with intracerebral hemorrhage has modestly risen over time. The clinical implications of this care pattern among patients with intracerebral hemorrhage require further study.
AB - Background And Purpose-: Many patients hospitalized with intracerebral hemorrhage are at high future risk for ischemic events and may benefit from stain therapy. However, little is known about patterns of statin prescription among patients with intracerebral hemorrhage, especially after the finding of higher hemorrhagic stroke risk in the statin treatment arm of the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial. We evaluated recent nationwide trends in discharge statin treatment after intracerebral hemorrhage hospitalization. Methods-: Using data from 25 673 patients with hemorrhagic stroke admitted to Get With Guidelines-Stroke participating hospitals between January 1, 2005, and December 31, 2007, we assessed factors associated with discharge statin prescription, including treatment over time and in relation to dissemination of the SPARCL Results. Piecewise logistic multivariable regression models were fit to track statin use in various periods. Results-: Mean age was 67.9±15 years, 48.1% female, and discharge statin treatment in 39.5%. Variables independently associated with lower discharge statin use included female sex (OR 0.87, 95% CI, 0.82 to 0.93), prior stroke/transient ischemic attack (OR 0.85, 95% CI, 0.78 to 0.92), academic center (OR 0.87, 95% CI, 0.82 to 0.93), and Midwest region (OR 0.65, 95% CI, 0.56 to 0.80). Statin prescription climbed over the study period from 66.9% to 74.5% (P<0.001) among eligible patients with a decrease during SPARCL reporting (P=0.03) and then a return to prior levels thereafter. Conclusions-: Discharge statin prescription among hospitalized patients with intracerebral hemorrhage has modestly risen over time. The clinical implications of this care pattern among patients with intracerebral hemorrhage require further study.
KW - clinical trials
KW - health services
KW - hemorrhagic stroke
KW - intracerebral hemorrhage
KW - practice patterns
KW - prevention
KW - statins
KW - utilization
UR - http://www.scopus.com/inward/record.url?scp=77957978880&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77957978880&partnerID=8YFLogxK
U2 - 10.1161/STROKEAHA.110.593228
DO - 10.1161/STROKEAHA.110.593228
M3 - Article
C2 - 20724709
AN - SCOPUS:77957978880
SN - 0039-2499
VL - 41
SP - 2271
EP - 2277
JO - Stroke
JF - Stroke
IS - 10
ER -