Department of Internal Medicine, National Health Insurance Service Medical Center, Ilsan Hospital, Goyangshi, Gyeonggi-do, Republic of Korea.
Research and Analysis Team, National Health Insurance Service Medical Center, Ilsan Hospital, Goyangshi, Gyeonggi-do, Republic of Korea.
Sci Rep. 2020 Nov 3;10(1):18964. doi: 10.1038/s41598-020-75888-8.
Polypharmacy is a growing and major public health issue, particularly in the geriatric population. This study aimed to examine the association between polypharmacy and the risk of hospitalization and mortality. We included 3,007,620 elderly individuals aged ≥ 65 years who had at least one routinely-prescribed medication but had no prior hospitalization within a year. The primary exposures of interest were number of daily prescribed medications (1-2, 3-4, 5-6, 7-8, 9-10, and ≥ 11) and presence of polypharmacy (≥ 5 prescription drugs per day). The corresponding comparators were the lowest number of medications (1-2) and absence of polypharmacy. The study outcomes were hospitalization and all-cause death. The median age of participants was 72 years and 39.5% were men. Approximately, 46.6% of participants experienced polypharmacy. Over a median follow-up of 5.0 years, 2,028,062 (67.4%) hospitalizations and 459,076 (15.3%) all-cause deaths were observed. An incrementally higher number of daily prescribed medications was found to be associated with increasingly higher risk for hospitalization and mortality. These associations were consistent across subgroups of age, sex, residential area, and comorbidities. Furthermore, polypharmacy was associated with greater risk of hospitalization and death: adjusted HRs (95% CIs) were 1.18 (1.18-1.19) and 1.25 (1.24-1.25) in the overall and 1.16 (1.16-1.17) and 1.25 (1.24-1.25) in the matched cohorts, respectively. Hence, polypharmacy was associated with a higher risk of hospitalization and all-cause death among elderly individuals.
题目： 老年人多病用药与住院和死亡风险的关系研究
摘要： 目的：研究多病用药与住院和死亡风险的关系。方法：本研究纳入了 3007620 名年龄≥65 岁、至少服用一种常规处方药但一年内无住院史的老年人。主要暴露因素为每日服用药物的数量（1-2 种、3-4 种、5-6 种、7-8 种、9-10 种和≥11 种）和多病用药的存在情况（每日≥5 种处方药）。相应的对照组为服用药物数量最少（1-2 种）和不存在多病用药。研究结果为住院和全因死亡。参与者的中位年龄为 72 岁，39.5%为男性。约 46.6%的参与者存在多病用药。在中位随访 5.0 年后，观察到 2028062 例（67.4%）住院和 459076 例（15.3%）全因死亡。随着每日服用药物数量的增加，住院和死亡的风险逐渐升高。这些关联在年龄、性别、居住地区和合并症的亚组中是一致的。此外，多病用药与更高的住院和死亡风险相关：总体调整后的 HR（95%CI）分别为 1.18（1.18-1.19）和 1.25（1.24-1.25），匹配队列中的调整后 HR（95%CI）分别为 1.16（1.16-1.17）和 1.25（1.24-1.25）。因此，多病用药与老年人住院和全因死亡风险增加相关。
