{"id":20376,"date":"2024-08-30T12:33:57","date_gmt":"2024-08-30T16:33:57","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&#038;p=20376"},"modified":"2024-09-11T12:38:55","modified_gmt":"2024-09-11T16:38:55","slug":"oral-anticoagulant-use-and-post-fall-mortality-in-long-term-care-home-residents","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/oral-anticoagulant-use-and-post-fall-mortality-in-long-term-care-home-residents\/","title":{"rendered":"Oral anticoagulant use and post-fall mortality in long-term care home residents"},"content":{"rendered":"<p><strong>Objectives<\/strong> \u2014 Long-term care (LTC) residents are susceptible to falling and the risk of subsequent morbidity and mortality may be compounded with concurrent anticoagulation use. Uncertainty exists around the benefit and harm of anticoagulation use for residents with a high risk for falls because of concerns of major bleeding complications. We aimed to examine if anticoagulant use increases mortality risk among LTC residents who fall.<\/p>\n<p><strong>Design<\/strong> \u2014 A retrospective cohort study.<\/p>\n<p><strong>Setting and participants <\/strong>\u2014 Older adults (\u226565 years) admitted to a LTC facility in Ontario, Canada between January 1, 2010, and December 1, 2019, who were transferred to emergency departments for fall-related injuries.<\/p>\n<p><strong>Methods<\/strong> \u2014 The exposure was the use of an oral anticoagulant (OAC). The primary outcome was mortality within 30 days of transfer. Secondary outcomes were major hemorrhage and care utilization. We used hierarchical logistic regression models to examine the association between the use of OAC and 30-day mortality.<\/p>\n<p><strong>Results <\/strong>\u2014 There were 56,419 residents transferred to the hospital for a fall, of whom 9611 (17.0%) were on an OAC. At 30 days, 5794 (10.3%) of the cohort had died: 12.0% (1151) on an OAC and 9.90% (4643) not on an OAC (risk difference [RD], 2.1%; 95% CI, 1.40%-2.82%). There were 485 major hemorrhage cases: 1.3% (125) on an OAC and 0.8% (360) not on an OAC (RD, 0.5%; 95% CI, 0.26%-0.74%). Multivariable analysis found no significant association between OAC use and 30-day mortality (odds ratio [OR], 0.98; 95% CI, 0.90-1.06), but an increased risk of major hemorrhage (OR, 1.31; 95% CI, 1.04-1.66). Both groups had similar health system and neurosurgical care utilization.<\/p>\n<p><strong>Conclusions and implications<\/strong> \u2014 Among LTC residents transferred to the emergency department for fall-related injuries, OACs did not increase the risk of post-fall mortality. OAC prescribing for frail older adults who experience falls should consider their individual risk profile.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Objectives \u2014 Long-term care (LTC) residents are susceptible to falling and the risk of subsequent morbidity and mortality may be compounded with concurrent anticoagulation use. Uncertainty exists around the benefit and harm of anticoagulation use for residents with a high risk for falls because of concerns of major bleeding complications. We aimed to examine if [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[55,32,17,56],"migration-helper-qa-sample-set":[],"class_list":["post-20376","journal_article","type-journal_article","status-publish","hentry","topic-injuries-and-accidents","topic-long-term-care-and-continuing-care","topic-older-people","topic-pharmacoepidemiology-and-drug-safety"],"acf":{"citation":"Yin CY, Scott M, Kimura M, Hakimjavadi R, Girard CI, Clarke A, Sood MM, Siegal DM, Tanuseputro P, Fung C, Sobala M, de Wit K, Hsu AT, Backman C, Kobewka D. <em>J Am Med Dir Assoc<\/em>. 2024; Aug 30 [Epub ahead of print].","source_url":"https:\/\/doi.org\/10.1016\/j.jamda.2024.105233","ices_scientist":[1107,1141,21611],"site":[6734],"research_program":[6740],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Oral anticoagulant use and post-fall mortality in long-term care home residents<\/title>\n<meta name=\"description\" content=\"Objectives \u2014 Long-term care (LTC) residents are susceptible to falling and the risk of subsequent morbidity and mortality may be compounded with\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" 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