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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.

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author
organization
publishing date
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
publisher
BioMed Central
external identifiers
  • scopus:84997284792
  • 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
2017-09-18 11:30:43
@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>},
  articleno    = {151},
  author       = {Härstedt, Maria and Rogmark, Cecilia and Sutton, Richard and Melander, Olle and Fedorowski, Artur},
  issn         = {1749-799X},
  keyword      = {Hip fracture,Mortality,Patient readmission,Polypharmacy},
  language     = {eng},
  month        = {11},
  number       = {1},
  publisher    = {BioMed Central},
  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},
  volume       = {11},
  year         = {2016},
}