Statin Treatment and Mortality in Community-Dwelling Frail Older Patients with Diabetes Mellitus: A Retrospective Observational Study
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{"title"=>"Statin treatment and mortality in community-dwelling frail older patients with diabetes mellitus: A retrospective observational study", "type"=>"journal", "authors"=>[{"first_name"=>"Alberto", "last_name"=>"Pilotto", "scopus_author_id"=>"7006878417"}, {"first_name"=>"Francesco", "last_name"=>"Panza", "scopus_author_id"=>"57190310649"}, {"first_name"=>"Massimiliano", "last_name"=>"Copetti", "scopus_author_id"=>"24474249000"}, {"first_name"=>"Matteo", "last_name"=>"Simonato", "scopus_author_id"=>"24340105000"}, {"first_name"=>"Daniele", "last_name"=>"Sancarlo", "scopus_author_id"=>"34880746900"}, {"first_name"=>"Pietro", "last_name"=>"Gallina", "scopus_author_id"=>"36891854400"}, {"first_name"=>"Timo", "last_name"=>"Strandberg", "scopus_author_id"=>"56962715500"}, {"first_name"=>"Alfonso", "last_name"=>"Cruz-Jentoft", "scopus_author_id"=>"6602479003"}, {"first_name"=>"Julia", "last_name"=>"Daragjati", "scopus_author_id"=>"55804833700"}, {"first_name"=>"Luigi", "last_name"=>"Ferrucci", "scopus_author_id"=>"55239601400"}, {"first_name"=>"Andrea", "last_name"=>"Fontana", "scopus_author_id"=>"35573405800"}, {"first_name"=>"Stefania", "last_name"=>"Maggi", "scopus_author_id"=>"7005091211"}, {"first_name"=>"Francesco", "last_name"=>"Mattace-Raso", "scopus_author_id"=>"10043191400"}, {"first_name"=>"Marc", "last_name"=>"Paccalin", "scopus_author_id"=>"55777426900"}, {"first_name"=>"Maria Cristina", "last_name"=>"Polidori", "scopus_author_id"=>"7003935714"}, {"first_name"=>"Ralf Joachim", "last_name"=>"Schulz", "scopus_author_id"=>"55737329800"}, {"first_name"=>"Eva", "last_name"=>"Topinkova", "scopus_author_id"=>"7003434686"}, {"first_name"=>"Gianluca", "last_name"=>"Trifirò", "scopus_author_id"=>"56577838700"}, {"first_name"=>"Anna Karin", "last_name"=>"Welmer", "scopus_author_id"=>"12041354500"}], "year"=>2015, "source"=>"PLoS ONE", "identifiers"=>{"pmid"=>"26110884", "doi"=>"10.1371/journal.pone.0130946", "sgr"=>"84938340869", "isbn"=>"1932-6203 (Electronic)\\r1932-6203 (Linking)", "scopus"=>"2-s2.0-84938340869", "issn"=>"19326203", "pui"=>"605398524"}, "id"=>"bec641f3-7125-3e77-860a-3560e3aa8394", "abstract"=>"BACKGROUND: Older adults are often excluded from clinical trials. Decision making for administration of statins to older patients with diabetes mellitus (DM) is under debate, particularly in frail older patients with comorbidity and high mortality risk. We tested the hypothesis that statin treatment in older patients with DM was differentially effective across strata of mortality risk assessed by the Multidimensional Prognostic Index (MPI), based on information collected with the Standardized Multidimensional Assessment Schedule for Adults and Aged Persons (SVaMA).\\n\\nMETHODS: In this retrospective observational study, we estimated the mortality risk in 1712 community-dwelling subjects with DM ≥ 65 years who underwent a SVaMA evaluation to establish accessibility to homecare services/nursing home admission from 2005 to 2013 in the Padova Health District, Italy. Mild (MPI-SVaMA-1), moderate (MPI-SVaMA-2), and high (MPI-SVaMA-3) risk of mortality at baseline and propensity score-adjusted hazard ratios (HR) of three-year mortality were calculated according to statin treatment.\\n\\nRESULTS: Higher MPI-SVaMA scores were associated with lower rates of statin treatment (MPI-SVaMA-1 = 39% vs MPI-SVaMA-2 = 36% vs MPI-SVaMA-3 = 24.9%. p<0.001) and higher three-year mortality (MPI-SVaMA-1 = 12.9% vs MPI-SVaMA-2 = 24% vs MPI-SVaMA-3 = 34.4%, p<0.001). After adjustment for propensity score quintiles, statin treatment was significantly associated with lower three-year mortality irrespective of MPI-SVaMA group (interaction test p = 0.303). HRs [95% confidence interval (CI)] were 0.19 (0.14-0.27), 0.28 (0.21-0.36), and 0.26 (0.20-0.34) in the MPI-SVaMA-1, MPI-SVaMA-2, and MPI-SVaMA-3 groups, respectively. Subgroup analyses showed that statin treatment was also beneficial irrespective of age. HRs (95% CI) were 0.21 (0.15-0.31), 0.26 (0.20-0.33), and 0.26 (0.20-0.35) among patients aged 65-74, 75-84, and ≥ 85 years, respectively (interaction test p=0.812).\\n\\nCONCLUSIONS: Statin treatment was significantly associated with reduced three-year mortality independently of age and multidimensional impairment in community-dwelling frail older patients with DM.", "link"=>"http://www.mendeley.com/research/statin-treatment-mortality-communitydwelling-frail-older-patients-diabetes-mellitus-retrospective-ob-2", "reader_count"=>18, "reader_count_by_academic_status"=>{"Professor > Associate Professor"=>1, "Librarian"=>2, "Researcher"=>3, "Student > Ph. D. Student"=>2, "Student > Postgraduate"=>1, "Student > Master"=>3, "Other"=>3, "Student > Bachelor"=>2, "Lecturer"=>1}, "reader_count_by_user_role"=>{"Professor > Associate Professor"=>1, "Librarian"=>2, "Researcher"=>3, "Student > Ph. D. Student"=>2, "Student > Postgraduate"=>1, "Student > Master"=>3, "Other"=>3, "Student > Bachelor"=>2, "Lecturer"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>2, "Nursing and Health Professions"=>1, "Medicine and Dentistry"=>11, "Agricultural and Biological Sciences"=>1, "Pharmacology, Toxicology and Pharmaceutical Science"=>1, "Social Sciences"=>1, "Computer Science"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>11}, "Social Sciences"=>{"Social Sciences"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>1}, "Computer Science"=>{"Computer Science"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>1}, "Unspecified"=>{"Unspecified"=>2}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>1}}, "reader_count_by_country"=>{"Netherlands"=>1, "Finland"=>1}, "group_count"=>1}

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/2150370", "https://ndownloader.figshare.com/files/2150371"], "description"=>"<div><p>Background</p><p>Older adults are often excluded from clinical trials. Decision making for administration of statins to older patients with diabetes mellitus (DM) is under debate, particularly in frail older patients with comorbidity and high mortality risk. We tested the hypothesis that statin treatment in older patients with DM was differentially effective across strata of mortality risk assessed by the Multidimensional Prognostic Index (MPI), based on information collected with the Standardized Multidimensional Assessment Schedule for Adults and Aged Persons (SVaMA).</p><p>Methods</p><p>In this retrospective observational study, we estimated the mortality risk in 1712 community-dwelling subjects with DM ≥ 65 years who underwent a SVaMA evaluation to establish accessibility to homecare services/nursing home admission from 2005 to 2013 in the Padova Health District, Italy. Mild (MPI-SVaMA-1), moderate (MPI-SVaMA-2), and high (MPI-SVaMA-3) risk of mortality at baseline and propensity score-adjusted hazard ratios (HR) of three-year mortality were calculated according to statin treatment.</p><p>Results</p><p>Higher MPI-SVaMA scores were associated with lower rates of statin treatment (MPI-SVaMA-1 = 39% vs MPI-SVaMA-2 = 36% vs MPI-SVaMA-3 = 24.9%. p<0.001) and higher three-year mortality (MPI-SVaMA-1 = 12.9% vs MPI-SVaMA-2 = 24% vs MPI-SVaMA-3 = 34.4%, p<0.001). After adjustment for propensity score quintiles, statin treatment was significantly associated with lower three-year mortality irrespective of MPI-SVaMA group (interaction test p = 0.303). HRs [95% confidence interval (CI)] were 0.19 (0.14–0.27), 0.28 (0.21–0.36), and 0.26 (0.20–0.34) in the MPI-SVaMA-1, MPI-SVaMA-2, and MPI-SVaMA-3 groups, respectively. Subgroup analyses showed that statin treatment was also beneficial irrespective of age. HRs (95% CI) were 0.21 (0.15–0.31), 0.26 (0.20–0.33), and 0.26 (0.20–0.35) among patients aged 65–74, 75–84, and ≥ 85 years, respectively (interaction test p=0.812).</p><p>Conclusions</p><p>Statin treatment was significantly associated with reduced three-year mortality independently of age and multidimensional impairment in community-dwelling frail older patients with DM.</p></div>", "links"=>[], "tags"=>["propensity score quintiles", "Standardized Multidimensional Assessment Schedule", "hr", "Retrospective Observational Study BackgroundOlder adults", "mpi", "mortality risk", "ci", "dm", "Padova Health District", "vs", "Multidimensional Prognostic Index", "interaction test p", "statin treatment", "0.26"], "article_id"=>1464803, "categories"=>["Uncategorised"], "users"=>["Alberto Pilotto", "Francesco Panza", "Massimiliano Copetti", "Matteo Simonato", "Daniele Sancarlo", "Pietro Gallina", "Timo Strandberg"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0130946.s001", "https://dx.doi.org/10.1371/journal.pone.0130946.s002"], "stats"=>{"downloads"=>7, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Statin_Treatment_and_Mortality_in_Community_Dwelling_Frail_Older_Patients_with_Diabetes_Mellitus_A_Retrospective_Observational_Study_/1464803", "title"=>"Statin Treatment and Mortality in Community-Dwelling Frail Older Patients with Diabetes Mellitus: A Retrospective Observational Study", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2015-06-25 04:25:54"}
  • {"files"=>["https://ndownloader.figshare.com/files/2150368"], "description"=>"<p>VADL: activities of daily living; VCOG: cognitive status; VIP: Nursing Care Needs; VMOB: mobility; VPIA: pressure sores risk; VSOC: social support</p><p>* Number of all medications per month, taken before the patient’s enrollment</p><p>^ ev/py: events/person-years, ir%: incidence rate (number of events per 100 person-years)</p><p>Baseline characteristics of community-dwelling older patients with diabetes mellitus divided according to their Multidimensional Prognostic Index (MPI) grade based on the Standardized Multidimensional Assessment Schedule for Adults and Aged Persons (SVaMA).</p>", "links"=>[], "tags"=>["propensity score quintiles", "Standardized Multidimensional Assessment Schedule", "hr", "Retrospective Observational Study BackgroundOlder adults", "mpi", "mortality risk", "ci", "dm", "Padova Health District", "vs", "Multidimensional Prognostic Index", "interaction test p", "statin treatment", "0.26"], "article_id"=>1464801, "categories"=>["Uncategorised"], "users"=>["Alberto Pilotto", "Francesco Panza", "Massimiliano Copetti", "Matteo Simonato", "Daniele Sancarlo", "Pietro Gallina", "Timo Strandberg"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0130946.t001", "stats"=>{"downloads"=>1, "page_views"=>22, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Baseline_characteristics_of_community_dwelling_older_patients_with_diabetes_mellitus_divided_according_to_their_Multidimensional_Prognostic_Index_MPI_grade_based_on_the_Standardized_Multidimensional_Assessment_Schedule_for_Adults_and_Aged_Persons_SVaMA_/1464801", "title"=>"Baseline characteristics of community-dwelling older patients with diabetes mellitus divided according to their Multidimensional Prognostic Index (MPI) grade based on the Standardized Multidimensional Assessment Schedule for Adults and Aged Persons (SVaMA).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-06-25 04:25:54"}
  • {"files"=>["https://ndownloader.figshare.com/files/2150369"], "description"=>"<p>VCOG: cognitive status; VIP: Nursing Care Needs; VPIA: pressure sores risk; VADL: activities of daily living; VMOB: mobility; VSOC: social support; MPI: Multidimensional Prognostic Index</p><p>MPI-SVaMA: Multidimensional Prognostic Index based on the Standardized Multidimensional Assessment Schedule for Adults and Aged Persons</p><p>* Number of all medications prescribed within one year before patient’s enrollment</p><p>Pre-matching baseline characteristics of community-dwelling older patients with diabetes mellitus according to statin use.</p>", "links"=>[], "tags"=>["propensity score quintiles", "Standardized Multidimensional Assessment Schedule", "hr", "Retrospective Observational Study BackgroundOlder adults", "mpi", "mortality risk", "ci", "dm", "Padova Health District", "vs", "Multidimensional Prognostic Index", "interaction test p", "statin treatment", "0.26"], "article_id"=>1464802, "categories"=>["Uncategorised"], "users"=>["Alberto Pilotto", "Francesco Panza", "Massimiliano Copetti", "Matteo Simonato", "Daniele Sancarlo", "Pietro Gallina", "Timo Strandberg"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0130946.t002", "stats"=>{"downloads"=>2, "page_views"=>23, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Pre_matching_baseline_characteristics_of_community_dwelling_older_patients_with_diabetes_mellitus_according_to_statin_use_/1464802", "title"=>"Pre-matching baseline characteristics of community-dwelling older patients with diabetes mellitus according to statin use.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-06-25 04:25:54"}

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Relative Metric

{"start_date"=>"2015-01-01T00:00:00Z", "end_date"=>"2015-12-31T00:00:00Z", "subject_areas"=>[]}
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