Suppr超能文献

慢性肾脏病老年患者的药物相关因素与再入院情况

Medication-Related Factors and Hospital Readmission in Older Adults with Chronic Kidney Disease.

作者信息

Tesfaye Wubshet H, Peterson Gregory M, Castelino Ronald L, McKercher Charlotte, Jose Matthew, Zaidi Syed Tabish R, Wimmer Barbara C

机构信息

Pharmacy, School of Medicine, College of Health and Medicine, University of Tasmania, Sandy Bay, TAS 7005, Australia.

Sydney Nursing School, The University of Sydney, Sydney, NSW 2006, Australia.

出版信息

J Clin Med. 2019 Mar 21;8(3):395. doi: 10.3390/jcm8030395.

Abstract

This study aimed to examine the association between medication-related factors and risk of hospital readmission in older patients with chronic kidney disease (CKD). A retrospective analysis was conducted targeting older CKD ( = 204) patients admitted to an Australian hospital. Medication appropriateness (Medication Appropriateness Index; MAI), medication regimen complexity (number of medications and Medication Regimen Complexity Index; MRCI) and use of selected medication classes were exposure variables. Outcomes were occurrence of readmission within 30 and 90 days, and time to readmission within 90 days. Logistic and Cox hazards regression were used to identify factors associated with readmission. Overall, 50 patients (24%) were readmitted within 30 days, while 81 (40%) were readmitted within 90 days. Mean time to readmission within 90 days was 66 (SD 34) days. Medication appropriateness and regimen complexity were not independently associated with 30- or 90-day hospital readmissions in older adults with CKD, whereas use of renin‒angiotensin blockers was associated with reduced occurrence of 30-day (adjusted OR 0.39; 95% CI 0.19⁻0.79) and 90-day readmissions (adjusted OR 0.45; 95% CI 0.24⁻0.84) and longer time to readmission within 90 days (adjusted HR 0.52; 95% CI 0.33⁻0.83). This finding highlights the importance of considering the potential benefits of individual medications during medication review in older CKD patients.

摘要

本研究旨在探讨慢性肾脏病(CKD)老年患者药物相关因素与再次入院风险之间的关联。对澳大利亚一家医院收治的老年CKD患者(n = 204)进行了回顾性分析。药物适宜性(药物适宜性指数;MAI)、药物治疗方案复杂性(药物数量和药物治疗方案复杂性指数;MRCI)以及特定药物类别的使用为暴露变量。观察结局为30天和90天内再次入院的发生情况,以及90天内再次入院的时间。采用逻辑回归和Cox风险回归来确定与再次入院相关的因素。总体而言,50例患者(24%)在30天内再次入院,81例(40%)在90天内再次入院。90天内再次入院的平均时间为66(标准差34)天。药物适宜性和治疗方案复杂性与CKD老年患者30天或90天再次入院无独立关联,而使用肾素 - 血管紧张素阻滞剂与30天再次入院发生率降低(调整后OR 0.39;95%CI 0.19 - 0.79)、90天再次入院发生率降低(调整后OR 0.45;95%CI 0.24 - 0.84)以及90天内再次入院时间延长(调整后HR 0.52;95%CI 0.33 - 0.83)相关。这一发现凸显了在老年CKD患者药物评估过程中考虑个体药物潜在益处的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0fbc/6462973/8e189f4ecc7c/jcm-08-00395-g001.jpg

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验