Association between acute geriatric syndromes and medication-related hospital admissions.

Abstract

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.

• Authors: Peter C Wierenga, Bianca M Buurman, Juliette L Parlevliet, Barbara C van Munster, Susanne M Smorenburg, Sharon K Inouye, Sophia E J A de Rooij
• Journal: Drugs & aging (Drugs Aging) Vol. 29 Issue 8 Pg. 691-9 (Aug 01 2012) ISSN: 1179-1969 [Electronic] New Zealand
• PMID: 22812539 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Topics

• Accidental Falls (statistics & numerical data)
• Acute Disease
• Aged
• Delirium (chemically induced, therapy)
• Female
• Hospitals (statistics & numerical data)
• Humans
• Male
• Patient Admission (statistics & numerical data)