Association between number of medications and mortality in geriatric inpatients: a Danish nationwide register-based coho
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RESEARCH PAPER
Association between number of medications and mortality in geriatric inpatients: a Danish nationwide register‑based cohort study Kristoffer Kittelmann Brockhattingen1,2 · Pavithra Laxsen Anru3,4 · Tahir Masud2,5,6 · Mirko Petrovic7 · Jesper Ryg2,6 Received: 29 June 2020 / Accepted: 27 August 2020 © European Geriatric Medicine Society 2020
Key summary points Aim To explore the association between number of medications and mortality in geriatric inpatients when adjusted for diseases and activities of daily living. Findings Increasing number of medications is associated with increased mortality. Every increase in number of medications by one is associated with a 3% increase in overall mortality. Message Evaluation of polypharmacy is important part of geriatric assessment when older adults are hospitalized. Abstract Purpose To explore the association between the number of medications and mortality in geriatric inpatients taking activities of daily living and comorbidities into account. Methods A nationwide population-based cohort study was performed including all patients aged ≥ 65 years admitted to geriatric departments in Denmark during 2005–2014. The outcome of interest was mortality. Activities of daily living using Barthel Index (BI) were measured at admission. National health registers were used to link data on an individual level extracting data on medications, and hospital diseases. Patients were followed to the end of study (31/12/2015), death, or emigration, which ever occurred first. Kaplan–Meier survival curves were used to estimate crude survival proportions. Univariable and multivariable analyses were performed using Cox regression. The multivariable analysis were adjusted for age, marital status, period of hospital admission, BMI, and BI (model 1), and additionally either number of diseases (model 2) or Charlson comorbidity index (model 3). Results We included 74,603 patients (62.8% women), with a median age of 83 (interquartile range [IQR] 77–88) years. Patients used a median of 6 (IQR 4–9) medications. Increasing number of medications was associated with increased overall, 30-day, and 1-year mortality in all three multivariable models for both men and women. For each extra medication, the mortality increased by 3% in women and 4% in men in the fully adjusted model. Conclusion Increasing number of medications was associated with mortality in this nationwide cohort of geriatric inpatients. Our findings highlight the importance of polypharmacy in older patients with comorbidities. Keywords Polypharmacy · Comorbidity · Mortality · Geriatric · Barthel · ADL
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s41999-020-00390-3) contains supplementary material, which is available to authorized users. * Kristoffer Kittelmann Brockhattingen [email protected] Extended author information available on the last page of the article
Geriatric inpatients are characterized and challenged by the presence of
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