Department of Geriatrics, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan.
Department of Geriatric Medicine, The University of Tokyo, Tokyo, Japan.
Geriatr Gerontol Int. 2024 Apr;24(4):404-409. doi: 10.1111/ggi.14860. Epub 2024 Mar 18.
The purpose of the present study was to clarify the association of pneumonia admission with polypharmacy and specific drug use in community-dwelling older people.
Using health insurance and long-term care insurance data from Kure city in Japan, we retrospectively collected data for older community-dwelling people (aged ≥65 years) from April 2017 to March 2019. The outcome was pneumonia admission. We carried out multivariate logistic regression analysis to identify the association of pneumonia admission with polypharmacy (≥5 drugs), the use of psychotropic drugs or anticholinergics with adjustment for patient backgrounds, such as comorbidity, and the daily life independence level for the older people with disability.
Of 59 040 older people, 4017 (6.8%) participants were admitted for pneumonia in 2 years. The ratio of polypharmacy, and the use of psychotropic drugs and anticholinergics in the admission group were significantly higher than the non-admission group. Multivariate logistic regression analysis showed that polypharmacy (odds ratio 1.29, 95% confidence interval 1.18-1.41), and the use of conventional antipsychotic drugs (odds ratio 1.39, 95% confidence interval 1.02-1.90), atypical antipsychotic drugs (odds ratio 1.67, 95% confidence interval 1.37-2.05) and anticholinergics (odds ratio 1.22, 95% confidence interval 1.13-1.33) were significantly associated with pneumonia admission.
The present results suggest that polypharmacy, and the use of psychotropic drugs and anticholinergics are risk factors for pneumonia admission. Geriatr Gerontol Int 2024; 24: 404-409.
本研究旨在阐明社区居住的老年人因肺炎入院与多种药物治疗及特定药物使用的相关性。
利用日本广岛市的医疗保险和长期护理保险数据,我们回顾性地收集了 2017 年 4 月至 2019 年 3 月期间年龄≥65 岁的社区居住老年人的数据。结局为肺炎入院。我们进行了多变量逻辑回归分析,以确定肺炎入院与多种药物治疗(≥5 种药物)、精神药物或抗胆碱能药物的使用与患者背景(如合并症)以及残疾老年人日常生活独立性水平的相关性。
在 59040 名老年人中,有 4017 名(6.8%)参与者在 2 年内因肺炎入院。入院组的多种药物治疗比例以及精神药物和抗胆碱能药物的使用比例显著高于未入院组。多变量逻辑回归分析显示,多种药物治疗(比值比 1.29,95%置信区间 1.18-1.41)、常规抗精神病药物(比值比 1.39,95%置信区间 1.02-1.90)、非典型抗精神病药物(比值比 1.67,95%置信区间 1.37-2.05)和抗胆碱能药物(比值比 1.22,95%置信区间 1.13-1.33)与肺炎入院显著相关。
本研究结果表明,多种药物治疗以及精神药物和抗胆碱能药物的使用是肺炎入院的危险因素。