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.
Rev Assoc Med Bras (1992). 2022 Nov 28;68(12):1730-1736. doi: 10.1590/1806-9282.20220907. eCollection 2022.
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.
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.
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).
Mortality was not associated with PIM. Older age and malnutrition were related to in-hospital mortality in COVID-19.
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。
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。
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）。
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。
