Polypharmacy and adverse outcomes after hip fracture surgery
File(s)
Published version
Author(s)
Härstedt, M
Rogmark, C
Sutton, R
Melander, O
Fedorowski, A
Type
Journal Article
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 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.
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.
Date Issued
2016-11-24
Date Acceptance
2016-11-12
Citation
Journal of Orthopaedic Surgery and Research, 2016, 11 (151)
ISSN
1749-799X
Publisher
BioMed Central
Journal / Book Title
Journal of Orthopaedic Surgery and Research
Volume
11
Issue
151
Copyright Statement
© 2016 The Authors. This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver
(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver
(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Identifier
http://www.ncbi.nlm.nih.gov/pubmed/27881180
PII: 10.1186/s13018-016-0486-7
Subjects
Hip fracture
Mortality
Patient readmission
Polypharmacy
Orthopedics
1103 Clinical Sciences
Publication Status
Published
Coverage Spatial
England