Department of Pharmacotherapy, School of Pharmacy, Nihon University, Chiba, Japan.
Department of Pharmacy, Hitachinaka General Hospital, Ibaraki, Japan.
Geriatr Gerontol Int. 2019 Jan;19(1):44-50. doi: 10.1111/ggi.13561. Epub 2018 Nov 29.
The association between potentially inappropriate medications (PIM) use and nutritional status is unclear in Japan. The aim of the present study was to establish whether PIM use during hospitalization affects the nutritional status among geriatric patients in the convalescing stage.
This retrospective longitudinal cohort study included consecutive geriatric patients admitted and discharged from convalescent rehabilitation wards between 2010 and 2016. Participants were divided based on the presence or absence of increased PIM from admission to discharge. Demographic data, laboratory data and the Functional Independence Measure were analyzed between groups. We used the 2015 American Geriatrics Society Beers Criteria to screen for PIM, and the primary outcome was the Geriatric Nutritional Risk Index at discharge. A multiple linear regression analysis was used to examine whether Geriatric Nutritional Risk Index at discharge was independently associated with increased PIM.
In total, 643 participants (220 men, 423 women; interquartile range 73-85 years) were included in the present study. Multiple linear regression analysis for increased PIM, adjusting for confounding factors, showed that PIM use was independently and negatively correlated with Geriatric Nutritional Risk Index at discharge. In particular, first-generation antihistamine, antipsychotic, benzodiazepine, proton pump inhibitor and non-steroidal anti- inflammatory drug use increased significantly from admission to discharge.
Increased PIM might be a predictor of nutritional status in geriatric patients. Geriatr Gerontol Int 2019; 19: 44-50.
在日本,潜在不适当药物(PIM)的使用与营养状况之间的关系尚不清楚。本研究旨在确定住院期间使用 PIM 是否会影响康复阶段老年患者的营养状况。
这是一项回顾性纵向队列研究,纳入了 2010 年至 2016 年期间连续入住和出院的康复病房的老年患者。根据入院至出院期间 PIM 是否增加,将参与者分为两组。对两组人群的人口统计学数据、实验室数据和功能独立性测量进行分析。我们使用 2015 年美国老年医学会 Beers 标准来筛选 PIM,主要结局指标为出院时的老年营养风险指数(GNRI)。采用多元线性回归分析,检验出院时 GNRI 是否与 PIM 增加独立相关。
本研究共纳入 643 名参与者(220 名男性,423 名女性;四分位间距为 73-85 岁)。对 PIM 增加进行多元线性回归分析,调整混杂因素后,结果显示 PIM 的使用与出院时的 GNRI 呈独立负相关。具体而言,第一代抗组胺药、抗精神病药、苯二氮䓬类药物、质子泵抑制剂和非甾体抗炎药的使用从入院到出院显著增加。
PIM 增加可能是老年患者营养状况的预测指标。老年医学与老年病学国际 2019;19:44-50。