药物治疗方案复杂指数评分对老年心力衰竭患者住院再入院的影响：一项回顾性队列研究。
Implications of the medication regimen complexity index score on hospital readmissions in elderly patients with heart failure: a retrospective cohort study.
机构信息
Pharmacy Department, Community and Home Health Services, Hamad Medical Corporation, Doha, Qatar.
Pharmacy Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
出版信息
BMC Geriatr. 2023 Jun 19;23(1):377. doi: 10.1186/s12877-023-04062-2.
BACKGROUND
The likelihood of elderly patients with heart failure (HF) being readmitted to the hospital is higher if they have a higher medication regimen complexity index (MRCI) compared to those with a lower MRCI. The objective of this study was to investigate whether there is a correlation between the MRCI score and the frequency of hospital readmissions (30-day, 90-day, and 1-year) among elderly patients with HF.
METHODS
In this single-center retrospective cohort study, MRCI scores were calculated using a well-established tool. Patients were categorized into high (≥ 15) or low (< 15) MRCI score groups. The primary outcome examined the association between MRCI scores and 30-day hospital readmission rates. Secondary outcomes included the relationships between MRCI scores and 90-day readmission, one-year readmission, and mortality rates. Multivariate logistic regression was employed to assess the 30- and 90-day readmission rates, while Kaplan-Meier analysis was utilized to plot mortality.
RESULTS
A total of 150 patients were included. The mean MRCI score for all patients was 33.43. 90% of patients had a high score. There was no link between a high MCRI score and a high 30-day readmission rate (OR 1.02; 95% CI 0.99-1.05; p < 0.13). A high MCRI score was associated with an initial significant increase in the 90-day readmission rate (odd ratio, 1.03; 95% CI, 1.00-1.07; p < 0.022), but not after adjusting for independent factors (odd ratio, 0.99; 95% CI, 0.95-1.03; p < 0.487). There was no significant difference between high and low MRCI scores in their one-year readmission rate.
CONCLUSION
The study's results indicate that there is no correlation between a higher MRCI score and the rates of hospital readmission or mortality among elderly patients with HF. Therefore, it can be concluded that the medication regimen complexity index does not appear to be a significant predictor of hospital readmission or mortality in this population.
背景
与药物治疗方案复杂度指数（MRCI）较低的患者相比，MRCI 较高的老年心力衰竭（HF）患者再次住院的可能性更高。本研究的目的是探讨 MRCI 评分与老年 HF 患者的住院再入院频率（30 天、90 天和 1 年）之间是否存在相关性。
方法
在这项单中心回顾性队列研究中，使用一种成熟的工具计算 MRCI 评分。患者分为高（≥15）或低（<15）MRCI 评分组。主要结局是检查 MRCI 评分与 30 天内住院再入院率之间的关联。次要结局包括 MRCI 评分与 90 天再入院、1 年再入院和死亡率之间的关系。采用多变量逻辑回归评估 30 天和 90 天再入院率，采用 Kaplan-Meier 分析绘制死亡率图。
结果
共纳入 150 例患者。所有患者的平均 MRCI 评分为 33.43。90%的患者评分较高。高 MRCI 评分与高 30 天再入院率之间没有联系（比值比 1.02；95%置信区间 0.99-1.05；p<0.13）。高 MCRI 评分与 90 天再入院率的初始显著增加相关（比值比，1.03；95%置信区间，1.00-1.07；p<0.022），但在调整独立因素后无差异（比值比，0.99；95%置信区间，0.95-1.03；p<0.487）。高和低 MRCI 评分在 1 年再入院率方面没有显著差异。
结论
研究结果表明，MRCI 评分较高与老年 HF 患者的住院再入院率或死亡率之间没有相关性。因此，可以得出结论，在该人群中，药物治疗方案复杂度指数似乎不是住院再入院或死亡率的重要预测因素。
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