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药物疗法过多是导致帕金森病住院的一个决定因素。

Polypharmacy is a determinant of hospitalization in Parkinson's disease.

机构信息

Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

出版信息

Eur Rev Med Pharmacol Sci. 2021 Jul;25(14):4810-4817. doi: 10.26355/eurrev_202107_26394.

Abstract

OBJECTIVE

Patients with Parkinson's disease (PD) are at a higher risk of hospitalization and recurrent hospitalizations, with consequent complications. Polypharmacy is associated with several adverse outcomes, including hospitalization, increased length of hospital stay, and mortality. The aim of this study was to evaluate among patients with PD the association between the number of medications and incident hospitalizations.

PATIENTS AND METHODS

We analysed the data of 165 patients with Parkinson's disease attending a geriatric Day Hospital who were enrolled in a cohort study and followed for a median of two years.

RESULTS

Over the follow-up, 46 participants (46%) were hospitalized at least one time; multiple admissions were observed in 12 subjects (7%). The median number of agents was 5 (4-7). In Cox regression, the number of drugs was associated with increased hospitalization rates (HR=1.23; 95% CI=1.06-1.43), also after excluding non-neurological medications (HR=1.18; 95% CI=1.01-1.38). Using Poisson regression, polypharmacy (i.e., use of >5 drugs) predicted the number of repeated hospitalizations (IRR=2.62; 95% CI=1.28-5.36; p=.008).

CONCLUSIONS

Among patients with PD, the number of daily medications is associated with increased risk of hospitalization; an increasing number of drugs is associated with increasing number of hospitalizations.

摘要

目的

帕金森病(PD)患者住院和再次住院的风险较高,随之而来的是并发症。多种药物治疗与多种不良结局相关,包括住院、住院时间延长和死亡。本研究旨在评估 PD 患者中药物数量与入院事件之间的关联。

方法

我们分析了参加老年日医院队列研究的 165 名 PD 患者的数据,并对其进行了中位数为两年的随访。

结果

在随访期间,46 名参与者(46%)至少住院一次;12 名患者(7%)观察到多次住院。药物中位数为 5 种(4-7 种)。在 Cox 回归中,药物数量与更高的住院率相关(HR=1.23;95%CI=1.06-1.43),在排除非神经科药物后也是如此(HR=1.18;95%CI=1.01-1.38)。使用泊松回归,多种药物治疗(即使用>5 种药物)预测重复住院的次数(IRR=2.62;95%CI=1.28-5.36;p=.008)。

结论

在 PD 患者中,每日用药数量与住院风险增加相关;药物数量的增加与住院次数的增加相关。

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