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基于 TIME 标准的潜在不适当药物与 COVID-19 患者住院死亡率的关系。

Potentially inappropriate medications based on TIME criteria and risk of in-hospital mortality in COVID-19 patients.

机构信息

Marmara University, Faculty of Medicine, Department of Internal Medicine, Division of Geriatrics - Pendik (Istanbul), Turkey.

Marmara University, Faculty of Medicine, Department of Chest Diseases and Intensive Care - Pendik (Istanbul), Turkey.

出版信息

Rev Assoc Med Bras (1992). 2022 Nov 28;68(12):1730-1736. doi: 10.1590/1806-9282.20220907. eCollection 2022.

Abstract

OBJECTIVE

This study aimed to evaluate the relationship between hospital admission potentially inappropriate medications use (PIM) and in-hospital mortality of COVID-19, considering other possible factors related to mortality.

METHODS

The Turkish inappropriate medication use in the elderly (TIME) criteria were used to define PIM. The primary outcome of this study was in-hospital mortality.

RESULTS

We included 201 older adults (mean age 73.1±9.4, 48.9% females). The in-hospital mortality rate and prevalence of PIM were 18.9% (n=38) and 96% (n=193), respectively. The most common PIM according to TIME to START was insufficient vitamin D and/or calcium intake per day. Proton-pump inhibitor use for multiple drug indications was the most prevalent PIM based on TIME to STOP findings. Mortality was related to PIM in univariate analysis (p=0.005) but not in multivariate analysis (p=0.599). Older age (hazards ratio (HR): 1.08; 95% confidence interval (CI): 1.02-1.13; p=0.005) and higher Nutritional Risk Screening 2002 (NRS-2002) scores were correlated with in-hospital mortality (HR: 1.29; 95%CI 1.00-1.65; p=0.042).

CONCLUSION

Mortality was not associated with PIM. Older age and malnutrition were related to in-hospital mortality in COVID-19.

摘要

目的

本研究旨在评估 COVID-19 住院患者潜在不适当药物使用(PIM)与院内死亡率之间的关系,同时考虑其他可能与死亡率相关的因素。

方法

使用土耳其老年人不适当药物使用(TIME)标准来定义 PIM。本研究的主要结局为院内死亡率。

结果

我们纳入了 201 名老年人(平均年龄 73.1±9.4 岁,48.9%为女性)。院内死亡率和 PIM 的发生率分别为 18.9%(n=38)和 96%(n=193)。根据 TIME 开始标准,最常见的 PIM 是每日摄入不足的维生素 D 和/或钙。根据 TIME 停止标准,质子泵抑制剂用于多种药物适应证是最常见的 PIM。在单因素分析中,死亡率与 PIM 相关(p=0.005),但在多因素分析中不相关(p=0.599)。年龄较大(风险比(HR):1.08;95%置信区间(CI):1.02-1.13;p=0.005)和较高的营养风险筛查 2002 评分(NRS-2002)与院内死亡率相关(HR:1.29;95%CI 1.00-1.65;p=0.042)。

结论

死亡率与 PIM 无关。年龄较大和营养不良与 COVID-19 患者的院内死亡率相关。

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