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Olle Melander

Principal investigator

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Polypharmacy and adverse outcomes after hip fracture surgery

Author

  • Maria Härstedt
  • Cecilia Rogmark
  • Richard Sutton
  • Olle Melander
  • Artur Fedorowski

Summary, in English

Background: We aimed to explore the effects of polypharmacy and specific drug classes on readmissions and mortality after hip surgery. Methods: We analyzed data on 272 consecutive hip fracture patients (72.1% females; age 82±9 years) who underwent acute hip replacement. We collected detailed data on the pharmacological treatment upon admission and discharge. Patients were followed up over a period of 6 months after discharge using the Swedish National Hospital Discharge Register and the Swedish National Cause of Death Register. Results: After 6 months, 86 patients (31.6%) were readmitted, while 36 patients (13.2%) died. The total number of medications upon discharge was predictive of rehospitalization (odds ratio (OR) 1.08, 95%CI 1.01-1.17, p = 0.030) but not predictive of mortality. The use of antiosteoporotic agents (OR 1.86, 95%CI 1.06-3.26, p = 0.03), SSRIs (OR 1.90, 95%CI 1.06-3.42, p = 0.03), and eye drops (OR 4.12, 95%CI 1.89-8.97, p = 0.0004) were predictive of rehospitalization. Treatment with vitamin K antagonists (OR 4.29, 95%CI 1.19-15.39, p = 0.026), thiazides (OR 4.10, 95%CI 1.30-12.91, p = 0.016), and tramadol (OR 2.84, 95%CI 1.17-6.90, p = 0.021) predicted readmissions due to a new fall/trauma. Conclusions: The total number of medications, use of antiosteoporotic agents, SSRIs, and eye drops predicted rehospitalization after hip fracture surgery, while use of vitamin K antagonists, thiazides, and tramadol was associated with readmissions due to a traumatic fall. Trial registration: Hip fractures and polypharmacy in the elderly. Stimulus Project for the Elderly 2009-2011 (Reg no 2009-11-26). Swedish National Board of Health and Welfare.

Department/s

  • Cardiovascular Research - Hypertension
  • EpiHealth: Epidemiology for Health

Publishing year

2016-11-24

Language

English

Publication/Series

Journal of Orthopaedic Surgery and Research

Volume

11

Issue

1

Document type

Journal article

Publisher

BioMed Central (BMC)

Topic

  • Orthopedics

Keywords

  • Hip fracture
  • Mortality
  • Patient readmission
  • Polypharmacy

Status

Published

Research group

  • Cardiovascular Research - Hypertension

ISBN/ISSN/Other

  • ISSN: 1749-799X