Literature DB >> 30907565

High-risk medications in older patients with trauma: a cross-sectional study of risk mitigation

Erica Lester1, Mark Dykstra1, Chantalle Grant1, Vanessa Fawcett1, Bonnie Tsang1, Sandy Widder1.   

Abstract

Background: The Beers Criteria for Potentially Inappropriate Medication Use inOlder Adults is a framework that can assess the nature of high-risk medication use. The objective of this study was to use the Beers Criteria to assess the prevalence and nature of polypharmacy, the magnitude of medication changes during the hospital stay and the impact of Beers Criteria medications on outcomes in older patients with trauma.
Methods: We used the Alberta Trauma Registry to conduct a retrospective review of patients aged 65 years or older with major trauma (Injury Severity Score ≥ 12) who were admitted to a level 1 trauma centre between January 2013 and December 2014. We analyzed changes in medication prescriptions during the hospital stay using descriptive statistics and assessed the association between Beers Criteria medications and relevant outcomes using multivariable regression analysis.
Results: There was no significant change in the number of Beers Criteria medications prescribed before and after admission. The adjusted odds ratio for 30-day mortality for each additional Beers Criteria medication prescribed was 2.02 (95% confidence interval [CI] 1.16–3.51) versus 1.24 (95% CI 1.04–1.59) for each additional medication of any type. The corresponding adjusted incidence rate ratios for length of stay were 1.15 (95% CI 1.03–1.30) versus 1.05 (95% CI 1.01–1.10).
Conclusion: Beers Criteria medications were not discontinued during trauma admissions. Using the Beers Criteria as a process indicator for quality improvement in trauma care may provide interdisciplinary trauma teams an opportunity to audit patient medications and stop potentially harmful medications in a vulnerable population.
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Year:  2019        PMID: 30907565      PMCID: PMC6440890          DOI: 10.1503/cjs.017117

Source DB:  PubMed          Journal:  Can J Surg        ISSN: 0008-428X            Impact factor:   2.089


  27 in total

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2.  Predictive Validity of the Beers and Screening Tool of Older Persons' Potentially Inappropriate Prescriptions (STOPP) Criteria to Detect Adverse Drug Events, Hospitalizations, and Emergency Department Visits in the United States.

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Review 4.  Immunesenescence and inflammaging: A contributory factor in the poor outcome of the geriatric trauma patient.

Authors:  Jon Hazeldine; Janet M Lord; Peter Hampson
Journal:  Ageing Res Rev       Date:  2015-10-17       Impact factor: 10.895

5.  Utilization and costs of health care after geriatric traumatic brain injury.

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Journal:  J Neurotrauma       Date:  2012-04-26       Impact factor: 5.269

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Journal:  J Trauma       Date:  2002-02
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  1 in total

Review 1.  Potentially inappropriate prescribing and its associations with health-related and system-related outcomes in hospitalised older adults: A systematic review and meta-analysis.

Authors:  Alemayehu B Mekonnen; Bernice Redley; Barbora de Courten; Elizabeth Manias
Journal:  Br J Clin Pharmacol       Date:  2021-05-18       Impact factor: 4.335

  1 in total

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