老年患者可能不适当的处方和医院结果

IF 0.4 Q4 GERONTOLOGY Journal of Gerontology and Geriatrics Pub Date : 2022-09-01 DOI:10.36150/2499-6564-n558
K. Elsorady, L. Matter, Dina S Abdelrahim
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引用次数: 0

摘要

背景和目的。高风险药物的使用在医院很常见,对体弱的老年人构成重大风险。该研究旨在确定老年患者潜在不适当处方(pip)与医院预后之间的关系。方法。一项包括152名老年人(年龄≥60岁)的回顾性队列研究。患者于2021年8月1日至2022年1月1日入住老年医院重症监护病房(ICU)。提取每位患者的年龄、性别、临床资料和入院期间使用的药物。目标结果是住院死亡率。根据老年人潜在不适当处方筛选工具第2版(STOPP v. 2)确定pip。进行Logistic回归分析以检验pip使用与院内死亡率之间的关联。对pip和接近生命末期的药物使用进行描述性统计。结果。67.8%(103例)的参与者出现pip。多因素回归分析显示,年龄较大是死亡率的独立预测因素(OR = 1.075;95% ci: 1.020-1.134;P .007),入院时谵妄/精神状态改变(OR = 2.688;95% ci: 1.086-6.651;P .032),使用≥3个pip (OR = 4.049;95% ci: 1.320-12.421;.014页)。谵妄或痴呆患者使用抗胆碱能药物是参与者中最常见的pip。结论。pip在住院老年人中很常见,且与死亡率显著相关。该研究概述了高风险药物,并建议对体弱多病的老年人进行结构化的药物审查和取消处方实践。
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Potentially Inappropriate Prescriptions and Hospital Outcome among Geriatric Patients
Background and aims . High risk medications use is common at hospitals and poses a major risk for frail older adults. The study aims to determine the association between Potentially Inappropriate Prescrip-tions (PIPs) and hospital outcome among geriatric patients. Methods . A retrospective cohort study including 152 older adults (age ≥ 60 years). These patients were admitted to the intensive care unit (ICU) at Geriatrics hospital from August 1 st , 2021 to January 1 st , 2022. Age, sex, clinical data and medications used throughout admission were extracted for each patient. The target outcome was in-hospital mortality. PIPs were identified in accordance with Screening Tool of Older Per-sons’ potentially inappropriate Prescriptions version 2 (STOPP v. 2). Logistic regression analysis was done to test the association between use of PIPs and in-hospital mortality. Descriptive statistics was performed for PIPs and medications use near the end of life. Results . PIPs occurred in 67.8% (103 patients) of participants. Multi-variate regression analysis revealed independent predictors of mortality including older age (OR = 1.075; 95% CI: 1.020-1.134; P .007), delirium/ altered mental status on admission (OR = 2.688; 95% CI: 1.086-6.651; P .032), and utilizing of ≥ 3 PIPs (OR = 4.049; 95% CI: 1.320-12.421; P .014). Use of anticholinergics in patients with delirium or dementia was the most frequently reported PIPs among participants. Conclu-sions. PIPs are common and significantly associated with mortality among hospitalized older adults. The study provides an overview for high risk medications and recommends a structured medication reviews and de-prescribing practice for frail older adults.
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来源期刊
CiteScore
0.70
自引率
0.00%
发文量
31
期刊介绍: The Journal of Gerontology and Geriatrics (JGG) is the official journal of the Italian Society of Gerontology and Geriatrics (SIGG), which will be an international, interdisciplinary, peer-reviewed journal concerning frontiers and advances in the field of aging. The aim of the journal is to provide a forum for original research papers, reviews, clinical case reports, and commentaries on the most relevant areas pertaining to aging. JGG publishes relevant articles covering the full range of disciplines pertaining to aging. Appropriate areas include (but are not limited to) Physiology and Pathology of Aging, Biogerontology, Epidemiology, Clinical Geriatrics, Pharmacology, Ethics, Psychology, Sociology and Geriatric Nursing.
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