Association between acute geriatric syndromes and medication-related hospital admissions.
BACKGROUND
Elderly patients are at a 4-fold higher risk of adverse drug events (ADEs) and drug-related hospitalization. Hospitalization of an elderly patient is often preceded by geriatric syndromes, like falls or delirium.


OBJECTIVE
The primary aim of this study was to investigate whether geriatric syndromes were associated with ADEs in acutely admitted elderly patients.


METHODS
Consecutive medical patients, aged 65 years or more, who were acutely admitted, were enrolled. An initial multidisciplinary evaluation was completed and baseline characteristics were collected. A fall before admission was retrieved from medical charts. Delirium was determined by the Confusion Assessment Method.


RESULTS
A total of 641 patients were included. Over 25% had an ADE present at admission, 26% presented with delirium and 12% with a fall. Delirium was associated with the use of antidepressants, antipsychotics and antiepileptics. In all ADEs (n = 167), ADEs were associated with a fall, with non-steroidal anti-inflammatory drugs or diuretics, but not with pre-existing functioning, delirium or older age. For ADEs involving psychoactive medication (n = 35), an association was found between delirium, falls, opioids and antipsychotics in bivariate analyses. A fall just before hospitalization (odds ratio [OR] 3.69 [95% CI 1.41, 9.67]), antipsychotics (OR 3.70 [95% CI 1.19, 11.60]) and opioids (OR 14.57 [95% CI 2.02, 105.30]) remained independently associated with an ADE involving psychoactive medication.


CONCLUSIONS
This prospective study demonstrated that, in a cohort of elderly hospital patients, a fall before admission and prevalent delirium are associated with several pharmacological groups and/or with ADE-related hospital admission.
Department of Clinical Pharmacy, Academic Medical Center, Amsterdam, the Netherlands.
Peter C
PC
Wierenga
Bianca M
BM
Buurman
Juliette L
JL
Parlevliet
Barbara C
BC
van Munster
Susanne M
SM
Smorenburg
Sharon K
SK
Inouye
Sophia E J A
SE
de Rooij
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000208:Acute Disease; D000368:Aged; D003693:Delirium / Q000139:chemically induced* / Q000628:therapy*; D005260:Female; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data*