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General and Risk Management, Patient Safety (including: medication errors, quality control)
Polypharmacy related with increased risk of hip fracture in the older patients
  1. O. Garcia,
  2. R. Jimenez,
  3. J. Velasco,
  4. V. Arocas,
  5. M.A. De la Rubia,
  6. F.J. Castellote
  1. 1University Hospital Arrixaca, pharmacia, murcia, Spain

Abstract

Background Polypharmacy and the use of a particular group of drugs including benzodiazepines, neuroleptics, antidepressants, antihypertensives, diuretics, acetylcholinesterase inhibitors and proton pump inhibitors have been associated with the risk of falls and subsequent hip fracture (HF).

Purpose Assess the association between polypharmacy and the use of drugs related to falls and analyse the mortality in older patients with HF.

Materials and methods This is a population-based retrospective case-control study. The case group consists of patients aged≥75 years admitted to a tertiary hospital with HF after accidental fall during the year 2010. 61 patients without HF of internal medicine service were randomised as the control group. To compare comorbidity between both groups Charlson index was used. SPSS was used to estimate update Bayesian OR and 95% credible intervals (CI).

Results 61 patients were admitted with HF. The relationship in the control group was 1:1. Mean age 83.3±4.8 years (60.7% women) for the case group versus 81.97±4.04, p=0.12. The number of drugs consumed was 7.2±3.3 in older with HF versus 4.9±2.1, p<0.05. Statistically significant differences were founded (p<0.05) in: benzodiazepines (OR 3.87, CI 1.77 to 8.46); antidepressants (OR 3.26, CI 1.18 to 9.02) and diuretics (OR 2.58, CI 1.24 to 5.39). The 34.42% of patients with HF died before 1 year, compared to 9.8% in the control group (p <0.05, OR 5.7, 95% CI 2.1 to 15). Mean Charlson index was 4.16 for HF and 3.62 for control group (p=0.14).

Conclusions The risk of HF in the older increases with the number of medications taken and the use of benzodiazepines, antidepressants and diuretics. The mortality in the older with HF is three times higher than the control group, which is consistent with published studies. These studies show death rate among 17–33% after the first year of suffering HF>.

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