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Multimorbidity and polypharmacy in hospitalized older patients: a cross-sectional study

BACKGROUND: The growing trend of ageing population has become a worldwide concern. In comparison with the youth, older people are more likely to suffer from multimorbidity and polypharmacy, both of which are associated with adverse outcomes and increased healthcare costs. This study aimed to investi...

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Autores principales: Zhao, Yong, Wang, Jianchun, Zhu, Xiaojuan, Zhang, Xiyu, Zhang, Yahui, Zhang, Wen, Dong, Yan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10334650/
https://www.ncbi.nlm.nih.gov/pubmed/37434147
http://dx.doi.org/10.1186/s12877-023-04109-4
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author Zhao, Yong
Wang, Jianchun
Zhu, Xiaojuan
Zhang, Xiyu
Zhang, Yahui
Zhang, Wen
Dong, Yan
author_facet Zhao, Yong
Wang, Jianchun
Zhu, Xiaojuan
Zhang, Xiyu
Zhang, Yahui
Zhang, Wen
Dong, Yan
author_sort Zhao, Yong
collection PubMed
description BACKGROUND: The growing trend of ageing population has become a worldwide concern. In comparison with the youth, older people are more likely to suffer from multimorbidity and polypharmacy, both of which are associated with adverse outcomes and increased healthcare costs. This study aimed to investigate the status of multimorbidity and polypharmacy in a large sample of hospitalized older patients aged 60 years and over. METHODS: A retrospective cross-sectional study was conducted among 46,799 eligible patients aged 60 years and over, who were hospitalized from January 1, 2021 to December 31, 2021. Multimorbidity was defined as the presence of 2 or more morbidities in one patient during the stay in hospital, and polypharmacy as prescription of 5 or more different oral medications. Spearman rank correlation analysis was used to assess the relationship of factors with the number of morbidities or oral medications. Odds ratio (OR) and 95% confidence interval (95% CI) were estimated from logistic regression models to determine the predictors for polypharmacy and all-cause death. RESULTS: The prevalence of multimorbidity was 91.07% and increased with age. The prevalence of polypharmacy was 56.32%. Older age, polypharmacy, prolonged length of stay (LOS), higher cost on medications were significantly associated with an increased number of morbidities (all P < 0.01). The number of morbidities (OR = 1.29, 95% CI: 1.208–1.229) and LOS (OR = 1.171, 95% CI: 1.166–1.177) were potential risk factors for polypharmacy. As for all-cause death, age (OR = 1.107, 95% CI: 1.092–1.122), number of morbidities (OR = 1.495, 95% CI: 1.435–1.558) and LOS (OR = 1.020, 95% CI: 1.013–1.027) were the potential risk factors, but the number of medications (OR = 0.930, 95% CI: 0.907–0.952) and polypharmacy (OR = 0.764, 95% CI: 0.608–0.960) were associated with a reduction of mortality. CONCLUSION: Morbidities and LOS might be predictors for polypharmacy and all-cause death. The number of oral medications was inversely associated with the risk of all-cause mortality. Appropriate polypharmacy was beneficial for the clinical outcomes of older patients during hospitalization. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-023-04109-4.
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spelling pubmed-103346502023-07-12 Multimorbidity and polypharmacy in hospitalized older patients: a cross-sectional study Zhao, Yong Wang, Jianchun Zhu, Xiaojuan Zhang, Xiyu Zhang, Yahui Zhang, Wen Dong, Yan BMC Geriatr Research BACKGROUND: The growing trend of ageing population has become a worldwide concern. In comparison with the youth, older people are more likely to suffer from multimorbidity and polypharmacy, both of which are associated with adverse outcomes and increased healthcare costs. This study aimed to investigate the status of multimorbidity and polypharmacy in a large sample of hospitalized older patients aged 60 years and over. METHODS: A retrospective cross-sectional study was conducted among 46,799 eligible patients aged 60 years and over, who were hospitalized from January 1, 2021 to December 31, 2021. Multimorbidity was defined as the presence of 2 or more morbidities in one patient during the stay in hospital, and polypharmacy as prescription of 5 or more different oral medications. Spearman rank correlation analysis was used to assess the relationship of factors with the number of morbidities or oral medications. Odds ratio (OR) and 95% confidence interval (95% CI) were estimated from logistic regression models to determine the predictors for polypharmacy and all-cause death. RESULTS: The prevalence of multimorbidity was 91.07% and increased with age. The prevalence of polypharmacy was 56.32%. Older age, polypharmacy, prolonged length of stay (LOS), higher cost on medications were significantly associated with an increased number of morbidities (all P < 0.01). The number of morbidities (OR = 1.29, 95% CI: 1.208–1.229) and LOS (OR = 1.171, 95% CI: 1.166–1.177) were potential risk factors for polypharmacy. As for all-cause death, age (OR = 1.107, 95% CI: 1.092–1.122), number of morbidities (OR = 1.495, 95% CI: 1.435–1.558) and LOS (OR = 1.020, 95% CI: 1.013–1.027) were the potential risk factors, but the number of medications (OR = 0.930, 95% CI: 0.907–0.952) and polypharmacy (OR = 0.764, 95% CI: 0.608–0.960) were associated with a reduction of mortality. CONCLUSION: Morbidities and LOS might be predictors for polypharmacy and all-cause death. The number of oral medications was inversely associated with the risk of all-cause mortality. Appropriate polypharmacy was beneficial for the clinical outcomes of older patients during hospitalization. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-023-04109-4. BioMed Central 2023-07-11 /pmc/articles/PMC10334650/ /pubmed/37434147 http://dx.doi.org/10.1186/s12877-023-04109-4 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Zhao, Yong
Wang, Jianchun
Zhu, Xiaojuan
Zhang, Xiyu
Zhang, Yahui
Zhang, Wen
Dong, Yan
Multimorbidity and polypharmacy in hospitalized older patients: a cross-sectional study
title Multimorbidity and polypharmacy in hospitalized older patients: a cross-sectional study
title_full Multimorbidity and polypharmacy in hospitalized older patients: a cross-sectional study
title_fullStr Multimorbidity and polypharmacy in hospitalized older patients: a cross-sectional study
title_full_unstemmed Multimorbidity and polypharmacy in hospitalized older patients: a cross-sectional study
title_short Multimorbidity and polypharmacy in hospitalized older patients: a cross-sectional study
title_sort multimorbidity and polypharmacy in hospitalized older patients: a cross-sectional study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10334650/
https://www.ncbi.nlm.nih.gov/pubmed/37434147
http://dx.doi.org/10.1186/s12877-023-04109-4
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