Polypharmacy, length of hospital stay, and in-hospital mortality among elderly patients in internal medicine wards. The REPOSI study.

Giuseppe Licata, Salvatore Corrao, Antonino Tuttolomondo, Luca Pasina, Carlotta Franchi, Pier Mannuccio Mannucci, Luigi De Vittorio, Maura Marcucci, Luca Pasina, Alessandra Marengoni, Mauro Tettamanti, Francesco Salerno, Alessandro Nobili, Alfonso Iorio

Risultato della ricerca: Article

147 Citazioni (Scopus)

Abstract

PURPOSES:We evaluated the prevalence and factors associated with polypharmacy and investigated the role of polypharmacy as a predictor of length of hospital stay and in-hospital mortality.METHODS:Thirty-eight internal medicine wards in Italy participated in the Registro Politerapie SIMI (REPOSI) study during 2008. One thousand three hundred and thirty-two in-patients aged ≥65 years were enrolled. Polypharmacy was defined as the concomitant use of five or more medications. Linear regression analyses were used to evaluate predictors of length of hospital stay and logistic regression models for predictors of in-hospital mortality. Age, sex, Charlson comorbidity index, polypharmacy, and number of in-hospital clinical adverse events (AEs) were used as possible confounders.RESULTS:The prevalence of polypharmacy was 51.9% at hospital admission and 67.0% at discharge. Age, number of drugs at admission, hypertension, ischemic heart disease, heart failure, and chronic obstructive pulmonary disease were independently associated with polypharmacy at discharge. In multivariate analysis, the occurrence of at least one AE while in hospital was the only predictor of prolonged hospitalization (each new AE prolonged hospital stay by 3.57 days, p < 0.0001). Age [odds ratio (OR) 1.04; 95% confidence interval (CI) 1.01-1.08; p = 0.02), comorbidities (OR 1.18; 95% CI 1.12-1.24; p < 0.0001), and AEs (OR 6.80; 95% CI 3.58-12.9; p < 0.0001) were significantly associated with in-hospital mortality.CONCLUSIONS:Although most elderly in-patients receive polypharmacy, in this study, it was not associated with any hospital outcome. However, AEs were strongly correlated with a longer hospital stay and higher mortality risk.
Lingua originaleEnglish
pagine (da-a)507-519
Numero di pagine13
RivistaEuropean Journal of Clinical Pharmacology
Volume67
Stato di pubblicazionePublished - 2011

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Polypharmacy
Internal Medicine
Hospital Mortality
Length of Stay
Odds Ratio
Confidence Intervals
Comorbidity
Logistic Models
Chronic Obstructive Pulmonary Disease
Italy
Myocardial Ischemia
Linear Models
Hospitalization
Multivariate Analysis
Heart Failure
Regression Analysis
Hypertension
Mortality
Pharmaceutical Preparations

All Science Journal Classification (ASJC) codes

  • Pharmacology
  • Pharmacology (medical)

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Polypharmacy, length of hospital stay, and in-hospital mortality among elderly patients in internal medicine wards. The REPOSI study. / Licata, Giuseppe; Corrao, Salvatore; Tuttolomondo, Antonino; Pasina, Luca; Franchi, Carlotta; Mannucci, Pier Mannuccio; De Vittorio, Luigi; Marcucci, Maura; Pasina, Luca; Marengoni, Alessandra; Tettamanti, Mauro; Salerno, Francesco; Nobili, Alessandro; Iorio, Alfonso.

In: European Journal of Clinical Pharmacology, Vol. 67, 2011, pag. 507-519.

Risultato della ricerca: Article

Licata, G, Corrao, S, Tuttolomondo, A, Pasina, L, Franchi, C, Mannucci, PM, De Vittorio, L, Marcucci, M, Pasina, L, Marengoni, A, Tettamanti, M, Salerno, F, Nobili, A & Iorio, A 2011, 'Polypharmacy, length of hospital stay, and in-hospital mortality among elderly patients in internal medicine wards. The REPOSI study.', European Journal of Clinical Pharmacology, vol. 67, pagg. 507-519.
Licata, Giuseppe ; Corrao, Salvatore ; Tuttolomondo, Antonino ; Pasina, Luca ; Franchi, Carlotta ; Mannucci, Pier Mannuccio ; De Vittorio, Luigi ; Marcucci, Maura ; Pasina, Luca ; Marengoni, Alessandra ; Tettamanti, Mauro ; Salerno, Francesco ; Nobili, Alessandro ; Iorio, Alfonso. / Polypharmacy, length of hospital stay, and in-hospital mortality among elderly patients in internal medicine wards. The REPOSI study. In: European Journal of Clinical Pharmacology. 2011 ; Vol. 67. pagg. 507-519.
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title = "Polypharmacy, length of hospital stay, and in-hospital mortality among elderly patients in internal medicine wards. The REPOSI study.",
abstract = "PURPOSES:We evaluated the prevalence and factors associated with polypharmacy and investigated the role of polypharmacy as a predictor of length of hospital stay and in-hospital mortality.METHODS:Thirty-eight internal medicine wards in Italy participated in the Registro Politerapie SIMI (REPOSI) study during 2008. One thousand three hundred and thirty-two in-patients aged ≥65 years were enrolled. Polypharmacy was defined as the concomitant use of five or more medications. Linear regression analyses were used to evaluate predictors of length of hospital stay and logistic regression models for predictors of in-hospital mortality. Age, sex, Charlson comorbidity index, polypharmacy, and number of in-hospital clinical adverse events (AEs) were used as possible confounders.RESULTS:The prevalence of polypharmacy was 51.9{\%} at hospital admission and 67.0{\%} at discharge. Age, number of drugs at admission, hypertension, ischemic heart disease, heart failure, and chronic obstructive pulmonary disease were independently associated with polypharmacy at discharge. In multivariate analysis, the occurrence of at least one AE while in hospital was the only predictor of prolonged hospitalization (each new AE prolonged hospital stay by 3.57 days, p < 0.0001). Age [odds ratio (OR) 1.04; 95{\%} confidence interval (CI) 1.01-1.08; p = 0.02), comorbidities (OR 1.18; 95{\%} CI 1.12-1.24; p < 0.0001), and AEs (OR 6.80; 95{\%} CI 3.58-12.9; p < 0.0001) were significantly associated with in-hospital mortality.CONCLUSIONS:Although most elderly in-patients receive polypharmacy, in this study, it was not associated with any hospital outcome. However, AEs were strongly correlated with a longer hospital stay and higher mortality risk.",
keywords = "Elderly Polypharmacy Hospital stay In-hospital mortality",
author = "Giuseppe Licata and Salvatore Corrao and Antonino Tuttolomondo and Luca Pasina and Carlotta Franchi and Mannucci, {Pier Mannuccio} and {De Vittorio}, Luigi and Maura Marcucci and Luca Pasina and Alessandra Marengoni and Mauro Tettamanti and Francesco Salerno and Alessandro Nobili and Alfonso Iorio",
year = "2011",
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volume = "67",
pages = "507--519",
journal = "European Journal of Clinical Pharmacology",
issn = "0031-6970",
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TY - JOUR

T1 - Polypharmacy, length of hospital stay, and in-hospital mortality among elderly patients in internal medicine wards. The REPOSI study.

AU - Licata, Giuseppe

AU - Corrao, Salvatore

AU - Tuttolomondo, Antonino

AU - Pasina, Luca

AU - Franchi, Carlotta

AU - Mannucci, Pier Mannuccio

AU - De Vittorio, Luigi

AU - Marcucci, Maura

AU - Pasina, Luca

AU - Marengoni, Alessandra

AU - Tettamanti, Mauro

AU - Salerno, Francesco

AU - Nobili, Alessandro

AU - Iorio, Alfonso

PY - 2011

Y1 - 2011

N2 - PURPOSES:We evaluated the prevalence and factors associated with polypharmacy and investigated the role of polypharmacy as a predictor of length of hospital stay and in-hospital mortality.METHODS:Thirty-eight internal medicine wards in Italy participated in the Registro Politerapie SIMI (REPOSI) study during 2008. One thousand three hundred and thirty-two in-patients aged ≥65 years were enrolled. Polypharmacy was defined as the concomitant use of five or more medications. Linear regression analyses were used to evaluate predictors of length of hospital stay and logistic regression models for predictors of in-hospital mortality. Age, sex, Charlson comorbidity index, polypharmacy, and number of in-hospital clinical adverse events (AEs) were used as possible confounders.RESULTS:The prevalence of polypharmacy was 51.9% at hospital admission and 67.0% at discharge. Age, number of drugs at admission, hypertension, ischemic heart disease, heart failure, and chronic obstructive pulmonary disease were independently associated with polypharmacy at discharge. In multivariate analysis, the occurrence of at least one AE while in hospital was the only predictor of prolonged hospitalization (each new AE prolonged hospital stay by 3.57 days, p < 0.0001). Age [odds ratio (OR) 1.04; 95% confidence interval (CI) 1.01-1.08; p = 0.02), comorbidities (OR 1.18; 95% CI 1.12-1.24; p < 0.0001), and AEs (OR 6.80; 95% CI 3.58-12.9; p < 0.0001) were significantly associated with in-hospital mortality.CONCLUSIONS:Although most elderly in-patients receive polypharmacy, in this study, it was not associated with any hospital outcome. However, AEs were strongly correlated with a longer hospital stay and higher mortality risk.

AB - PURPOSES:We evaluated the prevalence and factors associated with polypharmacy and investigated the role of polypharmacy as a predictor of length of hospital stay and in-hospital mortality.METHODS:Thirty-eight internal medicine wards in Italy participated in the Registro Politerapie SIMI (REPOSI) study during 2008. One thousand three hundred and thirty-two in-patients aged ≥65 years were enrolled. Polypharmacy was defined as the concomitant use of five or more medications. Linear regression analyses were used to evaluate predictors of length of hospital stay and logistic regression models for predictors of in-hospital mortality. Age, sex, Charlson comorbidity index, polypharmacy, and number of in-hospital clinical adverse events (AEs) were used as possible confounders.RESULTS:The prevalence of polypharmacy was 51.9% at hospital admission and 67.0% at discharge. Age, number of drugs at admission, hypertension, ischemic heart disease, heart failure, and chronic obstructive pulmonary disease were independently associated with polypharmacy at discharge. In multivariate analysis, the occurrence of at least one AE while in hospital was the only predictor of prolonged hospitalization (each new AE prolonged hospital stay by 3.57 days, p < 0.0001). Age [odds ratio (OR) 1.04; 95% confidence interval (CI) 1.01-1.08; p = 0.02), comorbidities (OR 1.18; 95% CI 1.12-1.24; p < 0.0001), and AEs (OR 6.80; 95% CI 3.58-12.9; p < 0.0001) were significantly associated with in-hospital mortality.CONCLUSIONS:Although most elderly in-patients receive polypharmacy, in this study, it was not associated with any hospital outcome. However, AEs were strongly correlated with a longer hospital stay and higher mortality risk.

KW - Elderly Polypharmacy Hospital stay In-hospital mortality

UR - http://hdl.handle.net/10447/74736

M3 - Article

VL - 67

SP - 507

EP - 519

JO - European Journal of Clinical Pharmacology

JF - European Journal of Clinical Pharmacology

SN - 0031-6970

ER -