title: Polypharmacy and adverse outcomes after hip fracture surgery.
abstract: BACKGROUND
  We aimed to explore the effects of polypharmacy and specific drug classes on readmissions and mortality after hip surgery.
  
  
  METHODS
  We analyzed data on 272 consecutive hip fracture patients (72.1% females; age 82 ± 9 years) who underwent acute hip replacement. We collected detailed data on the pharmacological treatment upon admission and discharge. Patients were followed up over a period of 6 months after discharge using the Swedish National Hospital Discharge Register and the Swedish National Cause of Death Register.
  
  
  RESULTS
  After 6 months, 86 patients (31.6%) were readmitted, while 36 patients (13.2%) died. The total number of medications upon discharge was predictive of rehospitalization (odds ratio (OR) 1.08, 95%CI 1.01-1.17, p = 0.030) but not predictive of mortality. The use of antiosteoporotic agents (OR 1.86, 95%CI 1.06-3.26, p = 0.03), SSRIs (OR 1.90, 95%CI 1.06-3.42, p = 0.03), and eye drops (OR 4.12, 95%CI 1.89-8.97, p = 0.0004) were predictive of rehospitalization. Treatment with vitamin K antagonists (OR 4.29, 95%CI 1.19-15.39, p = 0.026), thiazides (OR 4.10, 95%CI 1.30-12.91, p = 0.016), and tramadol (OR 2.84, 95%CI 1.17-6.90, p = 0.021) predicted readmissions due to a new fall/trauma.
  
  
  CONCLUSIONS
  The total number of medications, use of antiosteoporotic agents, SSRIs, and eye drops predicted rehospitalization after hip fracture surgery, while use of vitamin K antagonists, thiazides, and tramadol was associated with readmissions due to a traumatic fall.
  
  
  BACKGROUND
  Hip fractures and polypharmacy in the elderly. Stimulus Project for the Elderly 2009-2011 (Reg no 2009-11-26). Swedish National Board of Health and Welfare.
authors.affiliation: Department of Clinical Sciences, Malmö, Faculty of Medicine, Lund University, SE 205-02, Malmö, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Härstedt
authors.affiliation: Department of Orthopaedics, Skåne University Hospital, SE 205-02, Malmö, Sweden.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Rogmark
authors.affiliation: National Heart and Lung Institute, Imperial College London, St Mary's Hospital Campus, 59-61 North Wharf Road, London, W2 1LA, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Sutton
authors.affiliation: Department of Clinical Sciences, Malmö, Faculty of Medicine, Lund University, SE 205-02, Malmö, Sweden.|Department of Internal Medicine, Skåne University Hospital, SE 205-02, Malmö, Sweden.
authors.forename: Olle
authors.initials: O
authors.lastname: Melander
authors.affiliation: Department of Clinical Sciences, Malmö, Faculty of Medicine, Lund University, SE 205-02, Malmö, Sweden. artur.fedorowski@med.lu.se.|Department of Cardiology, Skåne University Hospital, Inga Marie Nilssons gata 46, SE 205-02, Malmö, Sweden. artur.fedorowski@med.lu.se.
authors.forename: Artur
authors.identifier: http://orcid.org/0000-0002-5352-6327
authors.initials: A
authors.lastname: Fedorowski
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects; D002423:Cause of Death / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006620:Hip Fractures / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D006760:Hospitalization / Q000639:trends; D006801:Humans; D008297:Male; D010359:Patient Readmission / Q000639:trends*; D019338:Polypharmacy; D011183:Postoperative Complications / Q000139:chemically induced / Q000175:diagnosis* / Q000401:mortality; D012042:Registries; D013548:Sweden / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D000925:Anticoagulants
keywords: Hip fracture; Mortality; Patient readmission; Polypharmacy