Polypharmacy and adverse outcomes after hip fracture surgery
Härstedt, Maria LU ; Rogmark, Cecilia LU ; Sutton, Richard ; Melander, Olle LU
and Fedorowski, Artur
LU
(2016)
In Journal of Orthopaedic Surgery and Research
11(1).
- Abstract
Background: We aimed to explore the effects of polypharmacy and specific drug classes on readmissions and mortality after hip surgery. Methods: We analyzed data on 272 consecutive hip fracture patients (72.1% females; age 82±9 years) who underwent acute hip replacement. We collected detailed data on the pharmacological treatment upon admission and discharge. Patients were followed up over a period of 6 months after discharge using the Swedish National Hospital Discharge Register and the Swedish National Cause of Death Register. Results: After 6 months, 86 patients (31.6%) were readmitted, while 36 patients (13.2%) died. The total number of medications upon discharge was predictive of rehospitalization (odds ratio (OR) 1.08, 95%CI... (More)
Background: We aimed to explore the effects of polypharmacy and specific drug classes on readmissions and mortality after hip surgery. Methods: We analyzed data on 272 consecutive hip fracture patients (72.1% females; age 82±9 years) who underwent acute hip replacement. We collected detailed data on the pharmacological treatment upon admission and discharge. Patients were followed up over a period of 6 months after discharge using the Swedish National Hospital Discharge Register and the Swedish National Cause of Death Register. Results: After 6 months, 86 patients (31.6%) were readmitted, while 36 patients (13.2%) died. The total number of medications upon discharge was predictive of rehospitalization (odds ratio (OR) 1.08, 95%CI 1.01-1.17, p = 0.030) but not predictive of mortality. The use of antiosteoporotic agents (OR 1.86, 95%CI 1.06-3.26, p = 0.03), SSRIs (OR 1.90, 95%CI 1.06-3.42, p = 0.03), and eye drops (OR 4.12, 95%CI 1.89-8.97, p = 0.0004) were predictive of rehospitalization. Treatment with vitamin K antagonists (OR 4.29, 95%CI 1.19-15.39, p = 0.026), thiazides (OR 4.10, 95%CI 1.30-12.91, p = 0.016), and tramadol (OR 2.84, 95%CI 1.17-6.90, p = 0.021) predicted readmissions due to a new fall/trauma. Conclusions: The total number of medications, use of antiosteoporotic agents, SSRIs, and eye drops predicted rehospitalization after hip fracture surgery, while use of vitamin K antagonists, thiazides, and tramadol was associated with readmissions due to a traumatic fall. Trial registration: Hip fractures and polypharmacy in the elderly. Stimulus Project for the Elderly 2009-2011 (Reg no 2009-11-26). Swedish National Board of Health and Welfare.
(Less)
- author
- Härstedt, Maria
LU
; Rogmark, Cecilia
LU
; Sutton, Richard
; Melander, Olle
LU
and Fedorowski, Artur
LU
- organization
- publishing date
- 2016-11-24
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Hip fracture, Mortality, Patient readmission, Polypharmacy
- in
- Journal of Orthopaedic Surgery and Research
- volume
- 11
- issue
- 1
- article number
- 151
- publisher
- BioMed Central (BMC)
- external identifiers
-
- scopus:84997284792
- pmid:27881180
- wos:000391333300002
- ISSN
- 1749-799X
- DOI
- 10.1186/s13018-016-0486-7
- language
- English
- LU publication?
- yes
- id
- b9b96a85-f143-47db-9500-5df51e4404cf
- date added to LUP
- 2016-12-09 09:42:03
- date last changed
- 2024-03-13 11:04:30
@article{b9b96a85-f143-47db-9500-5df51e4404cf,
abstract = {{<p>Background: We aimed to explore the effects of polypharmacy and specific drug classes on readmissions and mortality after hip surgery. Methods: We analyzed data on 272 consecutive hip fracture patients (72.1% females; age 82±9 years) who underwent acute hip replacement. We collected detailed data on the pharmacological treatment upon admission and discharge. Patients were followed up over a period of 6 months after discharge using the Swedish National Hospital Discharge Register and the Swedish National Cause of Death Register. Results: After 6 months, 86 patients (31.6%) were readmitted, while 36 patients (13.2%) died. The total number of medications upon discharge was predictive of rehospitalization (odds ratio (OR) 1.08, 95%CI 1.01-1.17, p = 0.030) but not predictive of mortality. The use of antiosteoporotic agents (OR 1.86, 95%CI 1.06-3.26, p = 0.03), SSRIs (OR 1.90, 95%CI 1.06-3.42, p = 0.03), and eye drops (OR 4.12, 95%CI 1.89-8.97, p = 0.0004) were predictive of rehospitalization. Treatment with vitamin K antagonists (OR 4.29, 95%CI 1.19-15.39, p = 0.026), thiazides (OR 4.10, 95%CI 1.30-12.91, p = 0.016), and tramadol (OR 2.84, 95%CI 1.17-6.90, p = 0.021) predicted readmissions due to a new fall/trauma. Conclusions: The total number of medications, use of antiosteoporotic agents, SSRIs, and eye drops predicted rehospitalization after hip fracture surgery, while use of vitamin K antagonists, thiazides, and tramadol was associated with readmissions due to a traumatic fall. Trial registration: Hip fractures and polypharmacy in the elderly. Stimulus Project for the Elderly 2009-2011 (Reg no 2009-11-26). Swedish National Board of Health and Welfare.</p>}},
author = {{Härstedt, Maria and Rogmark, Cecilia and Sutton, Richard and Melander, Olle and Fedorowski, Artur}},
issn = {{1749-799X}},
keywords = {{Hip fracture; Mortality; Patient readmission; Polypharmacy}},
language = {{eng}},
month = {{11}},
number = {{1}},
publisher = {{BioMed Central (BMC)}},
series = {{Journal of Orthopaedic Surgery and Research}},
title = {{Polypharmacy and adverse outcomes after hip fracture surgery}},
url = {{http://dx.doi.org/10.1186/s13018-016-0486-7}},
doi = {{10.1186/s13018-016-0486-7}},
volume = {{11}},
year = {{2016}},
}