Maki Hiroki, Wakabayashi Hidetaka, Maeda Keisuke, Nakamichi Mariko, Kubota Kazumi, Momosaki Ryo
Department of Pharmacy, Kofu Municipal Hospital.
Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital.
Ann Clin Epidemiol. 2023 Jul 4;5(3):88-94. doi: 10.37737/ace.23012. eCollection 2023.
The Comorbidity Polypharmacy Score (CPS) is calculated by the number of drugs carried plus the number of comorbidities on admission and divided into three categories (minor, 0-7; moderate, 8-14; and severe, 15+). This study investigates whether CPS can predict the clinical outcomes in older patients with hip fractures undergoing surgery.
This retrospective longitudinal study used a multicenter hospital-based database containing the Diagnosis Procedure Combination. Consecutive patients with hip fractures (ICD-10 codes S720 and S721) who were aged ≥65 years between April 2014 and August 2020 were included. We evaluated the predictive association between the CPS and Barthel Index (BI) efficiency. The primary outcome was defined as the BI efficiency, and the secondary outcome was the length of hospital stay.
We enrolled 11,564 patients, and 80.5% of them were female. The mean age was 83.9 ± 6.5 years. The BI efficiency was the lowest in the CPS severe group with a median [interquartile range] of 0.67 [0.10, 1.43]. The length of hospital stay was the highest in the CPS severe group, with a median of 35 [21, 58]. Additionally, multiple linear regression analysis revealed that the CPS was independently associated with the BI efficiency (β = -0.100, 95% CI: -0.040, -0.029; < 0.001) and the length of hospital stay (β = 0.047, 95% CI: 0.199, 0.366; < 0.001).
An increased CPS score is associated with low BI efficiency and longer length of hospital stay in patients with hip fractures.
合并症多重用药评分(CPS)通过入院时携带药物数量加上合并症数量计算得出,并分为三类(轻度,0 - 7;中度,8 - 14;重度,15及以上)。本研究调查CPS是否能预测接受手术的老年髋部骨折患者的临床结局。
这项回顾性纵向研究使用了一个基于多中心医院的包含诊断程序组合的数据库。纳入2014年4月至2020年8月期间年龄≥65岁的连续髋部骨折患者(国际疾病分类第十版编码S720和S721)。我们评估了CPS与巴氏指数(BI)效率之间的预测关联。主要结局定义为BI效率,次要结局为住院时间。
我们纳入了11564例患者,其中80.5%为女性。平均年龄为83.9±6.5岁。CPS重度组的BI效率最低,中位数[四分位间距]为0.67[0.10,1.43]。CPS重度组的住院时间最长,中位数为35[21,58]。此外,多元线性回归分析显示,CPS与BI效率独立相关(β = -0.100,95%置信区间:-0.040,-0.029;P < 0.001)以及住院时间(β = 0.047,95%置信区间:0.199,0.366;P < 0.001)。
CPS评分升高与髋部骨折患者的低BI效率和更长的住院时间相关。