Anticoagulation common at end of life in nursing home reside
Nearly one-third of nursing home residents with atrial fibrillation and advanced dementia stayed on anticoagulation in the last 6 months of life, according to a research letter published in JAMA Internal Medicine.

Researchers analyzed Medicare data to identify nursing home residents aged 65 years and older with advanced dementia and AF who had at least moderate stroke risk (CHA2DS2-VASC score 2) and who died from 2014 to 2017.

Among the cohort of 15,217 nursing home residents with AF and advanced dementia (68% women), 33% received an anticoagulant in the last 6 months of life.

In a multivariable analysis, higher CHA2DS2-VASC score, higher ATRIA score, nursing home length of stay of at least 1 year, not having Medicaid, weight loss, pressure ulcers and difficulty swallowing were associated with greater odds of anticoagulant use.

In contrast, age 80 to 89 years age 90 years or older, female sex, requiring restraints and enrollment in hospice were characteristics associated with less likely use of anticoagulants.