Association of Potentially Inappropriate Medications With All-Cause Mortality in the Elderly Acute Decompensated Heart Failure Patients: Importance of Nonsteroidal Anti-Inflammatory Drug Prescription
| Autor: | Toru Watanabe, Tomiko Sunaga, Miki Tsujiuchi, Sakura Nagumo, Azusa Yokoyama, Tadanori Sasaki, Saki Watanabe, Hiroshi Suzuki, Takuya Mizukami, Shoko Nakamura, Nagisa Miyamoto, Akihiro Nakamura, Mio Ebato, Ayaka Nogi, Hideyuki Maezawa |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Acute decompensated heart failure 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Interquartile range Internal medicine Medicine Multiple morbidities 030212 general & internal medicine Medical prescription Polypharmacy COPD business.industry STOPP criteria Retrospective cohort study medicine.disease Inappropriate Prescriptions Prognosis Elderly heart failure Cardiology Original Article Cardiology and Cardiovascular Medicine business Potentially inappropriate medications Non-steroidal anti-inflammatory drugs |
| Zdroj: | Cardiology Research |
| ISSN: | 1923-2829 |
| Popis: | Background: Acute decompensated heart failure (ADHF) is the most common cause of readmissions in the hospital. ADHF patients are associated with polypharmacy. It is a common problem among elderly patients due to frequently occurring multiple morbidities and is associated with the use of potentially inappropriate medications (PIMs). The aim of this study was to examine the association between PIMs and all-cause mortality in elderly ADHF patients. Methods: This retrospective study included ADHF patients who were admitted to the Showa University Fujigaoka Hospital between January 2015 and August 2016. We investigated the proportion of patients taking at least one PIM at admission and the characteristics of patients at admission. PIMs were defined based on the Screening Tool of Older People’s potentially inappropriate Prescriptions (STOPP). Multiple Cox regression analysis was performed to examine the association between PIM use and all-cause mortality. Results: A total of 193 elderly patients (median age 81 years, interquartile range (IQR) 65 - 99 years) were included in the study. All-cause death occurred in 30 patients. The median number of medications at admission was 7 (IQR 0 - 18). The number of medications (greater than or equal to six) at admission was associated with mortality. Multivariate Cox regression analysis revealed that systolic blood pressure (SBP) < 100 mm Hg at admission, chronic obstructive pulmonary disease (COPD), and use of non-steroidal anti-inflammatory drugs (NSAIDs) at admission were independent predictors for all-cause mortality. Conclusions: The medical staff should attempt to stop unnecessary medications that are prone to be inappropriate prescribing. In particular, prescription of NSAIDs should be carefully assessed and monitored. Cardiol Res. 2020;11(4):239-246 doi: https://doi.org/10.14740/cr1078 |
| Databáze: | OpenAIRE |
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