Injurious falls and subsequent adverse drug events among elderly - a Swedish population-based matched case-control study

Autor: Ute Bültmann, Lucie Laflamme, S.E. de Rooij, Jette Möller, Christian Rausch
Přispěvatelé: Lifelong Learning, Education & Assessment Research Network (LEARN), Public Health Research (PHR)
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Male
Pediatrics
Time Factors
Poison control
Comorbidity
Intention
lcsh:Geriatrics
Occupational safety and health
0302 clinical medicine
Registries
030212 general & internal medicine
adverse drug event
Cause of death
Aged
80 and over
education.field_of_study
Age Factors
ASSOCIATION
Middle Aged
PREVALENCE
Hospitalization
HOSPITAL ADMISSIONS
Female
Research Article
medicine.medical_specialty
Substance-Related Disorders
Population
Risk Assessment
VALIDATION
03 medical and health sciences
MEDICATION
PEOPLE
Injury prevention
medicine
Humans
injurious falls
education
OLDER-ADULTS
Aged
inappropriate drug use
REGISTER
Sweden
030214 geriatrics
business.industry
Case-control study
Odds ratio
medicine.disease
poisoning
lcsh:RC952-954.6
Case-Control Studies
GERIATRIC SYNDROMES
RISK-FACTORS
Wounds and Injuries
Accidental Falls
Geriatrics and Gerontology
business
Zdroj: BMC Geriatrics, 17(1). BioMed Central Ltd.
BMC Geriatrics
BMC Geriatrics, Vol 17, Iss 1, Pp 1-8 (2017)
ISSN: 1471-2318
Popis: Background Fall injuries are stressful and painful and they have a range of serious consequences for older people. While there is some clinical evidence of unintentional poisoning by medication following a severe fall injuries, population-based studies on that association are lacking. This is investigated in the current study, in which attention is also paid to different clinical conditions of the injured patients. Methods We conducted a matched case-control study of Swedish residents 60 years and older from various Swedish population-based registers. Cases defined as adverse drug events (ADE) by unintentional poisoning leading to hospitalization or death were extracted from the National Patient Register (NPR) and the Cause of Death Register from January 2006 to December 2009 (n = 4418). To each case, four controls were matched by sex, age and residential area. Information on injurious falls leading to hospitalization six months prior to the date of hospital admission or death from ADE by unintentional poisoning, and corresponding date for the controls, was extracted from the NPR. Data on clinical conditions, such as dispensed medications, comorbidity and previous fall injuries were also extracted from the Swedish Prescribed Drug Register (SPDR) and NPR. Effect estimates were calculated using conditional logistic regression and presented as odds ratios (OR) and 95% confidence intervals (CI). Results We found a three-fold increased risk of unintentional poisoning by medication in the six-month period after an injurious fall (OR 3.03; 95% CI, 2.54–3.74), with the most pronounced increase 1–3 weeks immediately after (OR, 7.66; 95% CI, 4.86–12.1). In that time window, from among those hospitalized for a fall (n = 92), those who sustained an unintentional poisoning (n = 60) tended to be in poorer health condition and receive more prescribed medications than those who did not, although this was not statistically significant. Age stratified analyses revealed a higher risk of poisoning among the younger (aged 60–79 years) than older elderly (80+ years). Conclusion Medication-related poisoning leading to hospitalization or death can be an ADE subsequent to an episode of hospitalization for a fall-related injury. Poisoning is more likely to occur closer to the injurious event and among the younger elderly. It cannot be ruled out that some of those falls are themselves ADE and early signs of greater vulnerability among certain patients. Electronic supplementary material The online version of this article (10.1186/s12877-017-0594-1) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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