Why the study?
Most nursing home residents with atrial fibrillation qualify for oral anticoagulants, but net clinical benefits may diminish as residents approach the end of life.
What factors are associated with the discontinuation of oral anticoagulants among nursing home residents with atrial fibrillation before hospice enrollment?
Population
30,503 US nursing home residents with atrial fibrillation who used OACs before hospice enrollment
Comparison
OAC discontinuation vs continuation before hospice enrollment
Design
Cross-sectional study
Key result
Among nursing home residents with atrial fibrillation, 45.7% discontinued oral anticoagulants prior to hospice enrollment, with higher discontinuation in those with high bleeding risk.
Authors
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High OAC discontinuation before hospice in AF residents warrants individualized end-of-life decisions; leaves open net benefit in advanced illness.
Cross-Sectional (n=30,503)
Yes
What factors are associated with the discontinuation of oral anticoagulants among nursing home residents with atrial fibrillation before hospice enrollment?
Nearly half of nursing home residents with atrial fibrillation discontinue oral anticoagulants before hospice enrollment, influenced by factors such as bleeding risk, cognitive impairment, and polypharmacy.
Chen et al. (2023) conducted a cross-sectional in Atrial fibrillation (n=30,503). Oral anticoagulant discontinuation vs. Continuation of oral anticoagulants was evaluated on Discontinuation of oral anticoagulants prior to hospice enrollment. Among nursing home residents with atrial fibrillation, 45.7% discontinued oral anticoagulants prior to hospice enrollment, with higher discontinuation in those with high bleeding risk.
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