Department of Geriatric Cardiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 JingWu Road, Jinan, 250021, Shandong, China.
Department of Geriatric Hematology Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.
BMC Geriatr. 2023 Jul 11;23(1):423. doi: 10.1186/s12877-023-04109-4.
The growing trend of ageing population has become a worldwide concern. In comparison with the youth, older people are more likely to suffer from multimorbidity and polypharmacy, both of which are associated with adverse outcomes and increased healthcare costs. This study aimed to investigate the status of multimorbidity and polypharmacy in a large sample of hospitalized older patients aged 60 years and over.
A retrospective cross-sectional study was conducted among 46,799 eligible patients aged 60 years and over, who were hospitalized from January 1, 2021 to December 31, 2021. Multimorbidity was defined as the presence of 2 or more morbidities in one patient during the stay in hospital, and polypharmacy as prescription of 5 or more different oral medications. Spearman rank correlation analysis was used to assess the relationship of factors with the number of morbidities or oral medications. Odds ratio (OR) and 95% confidence interval (95% CI) were estimated from logistic regression models to determine the predictors for polypharmacy and all-cause death.
The prevalence of multimorbidity was 91.07% and increased with age. The prevalence of polypharmacy was 56.32%. Older age, polypharmacy, prolonged length of stay (LOS), higher cost on medications were significantly associated with an increased number of morbidities (all P < 0.01). The number of morbidities (OR = 1.29, 95% CI: 1.208-1.229) and LOS (OR = 1.171, 95% CI: 1.166-1.177) were potential risk factors for polypharmacy. As for all-cause death, age (OR = 1.107, 95% CI: 1.092-1.122), number of morbidities (OR = 1.495, 95% CI: 1.435-1.558) and LOS (OR = 1.020, 95% CI: 1.013-1.027) were the potential risk factors, but the number of medications (OR = 0.930, 95% CI: 0.907-0.952) and polypharmacy (OR = 0.764, 95% CI: 0.608-0.960) were associated with a reduction of mortality.
Morbidities and LOS might be predictors for polypharmacy and all-cause death. The number of oral medications was inversely associated with the risk of all-cause mortality. Appropriate polypharmacy was beneficial for the clinical outcomes of older patients during hospitalization.
人口老龄化趋势的增长已成为全球关注的问题。与年轻人相比，老年人更容易患有多种疾病和多种药物治疗，这两者都与不良后果和增加医疗保健成本有关。本研究旨在调查在 60 岁及以上住院的大量老年患者中多种疾病和多种药物治疗的现状。
这是一项回顾性的横断面研究，共纳入了 46799 名符合条件的 60 岁及以上住院患者，他们在 2021 年 1 月 1 日至 2021 年 12 月 31 日期间住院。多种疾病被定义为患者在住院期间存在 2 种或多种疾病，多种药物治疗被定义为开具 5 种或更多种不同的口服药物。采用 Spearman 秩相关分析评估与疾病数量或口服药物数量相关的因素之间的关系。使用逻辑回归模型估计优势比（OR）和 95%置信区间（95%CI），以确定多种药物治疗和全因死亡的预测因素。
多种疾病的患病率为 91.07%，并随年龄增长而增加。多种药物治疗的患病率为 56.32%。年龄较大、多种药物治疗、住院时间延长（LOS）和药物费用较高与疾病数量的增加显著相关（均 P<0.01）。疾病数量（OR=1.29，95%CI：1.208-1.229）和 LOS（OR=1.171，95%CI：1.166-1.177）是多种药物治疗的潜在危险因素。至于全因死亡，年龄（OR=1.107，95%CI：1.092-1.122）、疾病数量（OR=1.495，95%CI：1.435-1.558）和 LOS（OR=1.020，95%CI：1.013-1.027）是潜在的危险因素，但药物数量（OR=0.930，95%CI：0.907-0.952）和多种药物治疗（OR=0.764，95%CI：0.608-0.960）与降低死亡率相关。
疾病数量和 LOS 可能是多种药物治疗和全因死亡的预测因素。口服药物的数量与全因死亡率的风险呈负相关。适当的多种药物治疗有利于住院老年患者的临床结局。
