TY - JOUR
T1 - Association between Acute Geriatric Syndromes and Medication-Related Hospital Admissions
AU - Wierenga, Peter C.
AU - Buurman, Bianca M.
AU - Parlevliet, Juliette L.
AU - van Munster, Barbara C.
AU - Smorenburg, Susanne M.
AU - Inouye, Sharon K.
AU - de Rooij, Sophia E. J. A.
N1 - Payment necessary for article.
PY - 2012/8
Y1 - 2012/8
N2 - BACKGROUND: Elderly patients are at a 4-fold higher risk of adverse drug events (ADEs) and drug-related hospitalization. Hospitalization of an elderly patient is often preceded by geriatric syndromes, like falls or delirium.OBJECTIVES: The primary aim of this study was to investigate whether geriatric syndromes were associated with ADEs in acutely admitted elderly patients.METHODS: Consecutive medical patients, aged 65 years or more, who were acutely admitted, were enrolled. An initial multidisciplinary evaluation was completed and baseline characteristics were collected. A fall before admission was retrieved from medical charts. Delirium was determined by the Confusion Assessment Method.RESULTS: A total of 641 patients were included. Over 25% had an ADE present at admission, 26% presented with delirium and 12% with a fall. Delirium was associated with the use of antidepressants, antipsychotics and antiepileptics. In all ADEs (n = 167), ADEs were associated with a fall, with non-steroidal anti-inflammatory drugs or diuretics, but not with pre-existing functioning, delirium or older age. For ADEs involving psychoactive medication (n = 35), an association was found between delirium, falls, opioids and antipsychotics in bivariate analyses. A fall just before hospitalization (odds ratio [OR] 3.69 [95% CI 1.41, 9.67]), antipsychotics (OR 3.70 [95% CI 1.19, 11.60]) and opioids (OR 14.57 [95% CI 2.02, 105.30]) remained independently associated with an ADE involving psychoactive medication.CONCLUSION: This prospective study demonstrated that, in a cohort of elderly hospital patients, a fall before admission and prevalent delirium are associated with several pharmacological groups and/or with ADE-related hospital admission.
AB - BACKGROUND: Elderly patients are at a 4-fold higher risk of adverse drug events (ADEs) and drug-related hospitalization. Hospitalization of an elderly patient is often preceded by geriatric syndromes, like falls or delirium.OBJECTIVES: The primary aim of this study was to investigate whether geriatric syndromes were associated with ADEs in acutely admitted elderly patients.METHODS: Consecutive medical patients, aged 65 years or more, who were acutely admitted, were enrolled. An initial multidisciplinary evaluation was completed and baseline characteristics were collected. A fall before admission was retrieved from medical charts. Delirium was determined by the Confusion Assessment Method.RESULTS: A total of 641 patients were included. Over 25% had an ADE present at admission, 26% presented with delirium and 12% with a fall. Delirium was associated with the use of antidepressants, antipsychotics and antiepileptics. In all ADEs (n = 167), ADEs were associated with a fall, with non-steroidal anti-inflammatory drugs or diuretics, but not with pre-existing functioning, delirium or older age. For ADEs involving psychoactive medication (n = 35), an association was found between delirium, falls, opioids and antipsychotics in bivariate analyses. A fall just before hospitalization (odds ratio [OR] 3.69 [95% CI 1.41, 9.67]), antipsychotics (OR 3.70 [95% CI 1.19, 11.60]) and opioids (OR 14.57 [95% CI 2.02, 105.30]) remained independently associated with an ADE involving psychoactive medication.CONCLUSION: This prospective study demonstrated that, in a cohort of elderly hospital patients, a fall before admission and prevalent delirium are associated with several pharmacological groups and/or with ADE-related hospital admission.
KW - Discharge Summary
KW - Geriatric Syndrome
KW - Medical Record Abstraction
KW - Pharmacological Group
KW - Psychoactive Medication
U2 - https://doi.org/10.1007/BF03262284
DO - https://doi.org/10.1007/BF03262284
M3 - Article
C2 - 22812539
SN - 1170-229X
VL - 29
SP - 691
EP - 699
JO - Drugs & aging
JF - Drugs & aging
IS - 8
ER -