Patterns and predictors of discharge statin prescription among hospitalized patients with intracerebral hemorrhage

Bruce Ovbiagele, Lee H. Schwamm, Eric E. Smith, Adrian F. Hernandez, Daiwai M. Olson, Wenqin Pan, Gregg C. Fonarow, Jeffrey L. Saver

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)2271-2277
Number of pages7
JournalStroke
Volume41
Issue number10
DOIs
StatePublished - Oct 2010

Fingerprint

Hydroxymethylglutaryl-CoA Reductase Inhibitors
Cerebral Hemorrhage
Prescriptions
Stroke
Cholesterol
Therapeutics
Transient Ischemic Attack
Hospitalization
Coloring Agents
Logistic Models
Guidelines

Keywords

  • clinical trials
  • health services
  • hemorrhagic stroke
  • intracerebral hemorrhage
  • practice patterns
  • prevention
  • statins
  • utilization

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Clinical Neurology
  • Advanced and Specialized Nursing
  • Medicine(all)

Cite this

Ovbiagele, B., Schwamm, L. H., Smith, E. E., Hernandez, A. F., Olson, D. M., Pan, W., ... Saver, J. L. (2010). Patterns and predictors of discharge statin prescription among hospitalized patients with intracerebral hemorrhage. Stroke, 41(10), 2271-2277. https://doi.org/10.1161/STROKEAHA.110.593228

Patterns and predictors of discharge statin prescription among hospitalized patients with intracerebral hemorrhage. / Ovbiagele, Bruce; Schwamm, Lee H.; Smith, Eric E.; Hernandez, Adrian F.; Olson, Daiwai M.; Pan, Wenqin; Fonarow, Gregg C.; Saver, Jeffrey L.

In: Stroke, Vol. 41, No. 10, 10.2010, p. 2271-2277.

Research output: Contribution to journalArticle

Ovbiagele, B, Schwamm, LH, Smith, EE, Hernandez, AF, Olson, DM, Pan, W, Fonarow, GC & Saver, JL 2010, 'Patterns and predictors of discharge statin prescription among hospitalized patients with intracerebral hemorrhage', Stroke, vol. 41, no. 10, pp. 2271-2277. https://doi.org/10.1161/STROKEAHA.110.593228
Ovbiagele, Bruce ; Schwamm, Lee H. ; Smith, Eric E. ; Hernandez, Adrian F. ; Olson, Daiwai M. ; Pan, Wenqin ; Fonarow, Gregg C. ; Saver, Jeffrey L. / Patterns and predictors of discharge statin prescription among hospitalized patients with intracerebral hemorrhage. In: Stroke. 2010 ; Vol. 41, No. 10. pp. 2271-2277.
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abstract = "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.",
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AU - Schwamm, Lee H.

AU - Smith, Eric E.

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AU - Olson, Daiwai M.

AU - Pan, Wenqin

AU - Fonarow, Gregg C.

AU - Saver, Jeffrey L.

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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.

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