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住院老年患者的身体表现测量和多重用药:来自 CRIME 研究的结果。

Physical performance measures and polypharmacy among hospitalized older adults: results from the CRIME study.

机构信息

Federica Sganga, Centro Medicina dellrsquor;Invecchiamento, Department of Gerontology, Neuroscience and Orthopedics, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168, Roma, Italy, Tel. +39 06 30154341, Fax +39 06 3051911, E-mail:

出版信息

J Nutr Health Aging. 2014;18(6):616-21. doi: 10.1007/s12603-014-0029-z.

Abstract

OBJECTIVE

To investigate the association of polypharmacy and physical performance measures in a sample of elderly patients aged ≥65 years admitted to acute care hospitals.

DESIGN, SETTING AND PARTICIPANTS: Prospective study conducted among 1123 hospitalized older adults participating to the CRiteria to Assess Appropriate Medication Use among Elderly Complex Patients (CRIME) project.

MEASUREMENTS

Physical performance was measured at hospital admission by the 4-meter walking speed (WS) and the grip strength (GS). Polypharmacy was defined as the use of ≥10 drugs during hospital stay.

RESULTS

Mean age of 1123 participants was 81.5±7.4 years and 576 (51.3%) were on polypharmacy. Prevalence of polypharmacy was higher in patients with low WS and GS. After adjusting for potential confounders, participants in the highest tertile of WS were less likely to be on polypharmacy as compared with those in the lowest tertile (OR 0.58; 95% CI 0.35 - 0.96). Similarly, participants in the highest tertile of GS had a significantly lower likelihood of polypharmacy as compared with those in the lowest tertile (OR 0.55; 95% CI 0.36 - 0.84). When examined as continuous variables, WS and GS were inversely associated with polypharmacy (WS: OR 0.77 per 1 SD increment; 95% CI 0.60 - 0.98; GS: OR 0.71 per 1 SD increment; 95% CI 0.56 - 0.90).

CONCLUSION

Among hospitalized older adults WS and GS are inversely related to polypharmacy. These measures should be incorporated in standard assessment of in-hospital patients.

摘要

目的

调查在≥ 65 岁的住院老年患者样本中,多种药物治疗与身体表现测量指标之间的关联。

设计、地点和参与者:在参与评估老年复杂患者适当药物使用标准(CRIME)项目的 1123 名住院老年人中进行了前瞻性研究。

测量

在入院时通过 4 米步行速度(WS)和握力(GS)来测量身体表现。多种药物治疗定义为在住院期间使用≥ 10 种药物。

结果

1123 名参与者的平均年龄为 81.5±7.4 岁,其中 576 人(51.3%)正在接受多种药物治疗。WS 和 GS 较低的患者中,多种药物治疗的患病率更高。在调整了潜在的混杂因素后,WS 最高三分位数的参与者使用多种药物治疗的可能性较 WS 最低三分位数的参与者降低(OR 0.58;95% CI 0.35 - 0.96)。同样,GS 最高三分位数的参与者使用多种药物治疗的可能性明显低于 GS 最低三分位数的参与者(OR 0.55;95% CI 0.36 - 0.84)。当作为连续变量进行检查时,WS 和 GS 与多种药物治疗呈负相关(WS:每 1 个标准差增加的 OR 为 0.77;95% CI 0.60 - 0.98;GS:每 1 个标准差增加的 OR 为 0.71;95% CI 0.56 - 0.90)。

结论

在住院的老年患者中,WS 和 GS 与多种药物治疗呈负相关。这些措施应纳入住院患者的标准评估中。

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