Table 2

Demographic and clinical/pharmacological factors of patients whose medication file was reviewed

Cardiology (n=72 (100%))Pulmonology (n=29 (100%))Rehabilitation (n=30 (100%))Total (n=131 (100%))
Age (≥65 years)56(78%)15(52%)12(40%)83(63%)
Gender (female)31(43%)10(34%)11(37%)52(40%)
Renal function disorder (eGFR <60 mL/min/1.73 m2)35(49%)4(14%)4(13%)43(33%)
Liver function disorder (Child-Pugh score ≥B)0(0%)1(3%)0(0%)1(1%)
Comorbidities (n ≥1)63(88%)16(55%)8(27%)87(66%)
Obesity (BMI >30/body weight M >120 kg/F >100 kg)5(7%)1(3%)0(0%)6(5%)
Delirium (use of haloperidol or abstraction from file)2(3%)2(7%)1(3%)5(4%)
Use of benzodiazepines during daytime8(11%)2(7%)5(17%)15(11%)
Prescription of renally cleared drugs with narrow TI*11(15%)2(7%)1(3%)14(11%)
Prescription of therapeutic dosed anticoagulants40(56%)8(28%)4(13%)52(40%)
Prescription of platelet aggregation inhibitors39(54%)UU3(10%)42(32%)
Polypharmacy (use of ≥5 drugs chronically)65(90%)18(62%)17(57%)100(76%)
ICU stay current hospitalisation4(6%)0(0%)0(0%)4(3%)
  • *Renally cleared drugs with narrow therapeutic indices (digoxine, lithium, sotalol, aminoglycosides, methotrexate).

  • BMI, body mass index; eGFR, estimated glomerular filtration rate; F, female; ICU, intensive care unit; M, male; TI, therapeutic indices; U, undefined.