Medication and medical diagnosis as risk factors for falls in older hospitalized patients.
Objective: To examine the impact of medication and medical conditions on the fall risk in older hospitalized patients. Design: Matched case-control study. Setting: Large regional hospital in a mid-sized German city. Subjects: Four hundred eighty-one inpatients aged ≥ 65 years who fell during hospita...
| Publicado en: | European Journal of Clinical Pharmacology Vol. 75; no. 8; pp. 1117 - 1125 |
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| Autores principales: | , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Aug2019
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=137507143&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 137507143 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00316970 NP9 jtl: European Journal of Clinical Pharmacology issn: 00316970 maglogo: N pubinfo: dt: Aug2019 vid: 75 iid: 8 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 137507143 137507143 137507143 10.1007/s00228-019-02668-3 137507143 ppf: 1117 ppct: 8 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Medication and medical diagnosis as risk factors for falls in older hospitalized patients. aug: au: Wedmann, Fabian Himmel, Wolfgang Nau, Roland affil: Department of Geriatrics, Evangelisches Krankenhaus Göttingen-Weende, An der Lutter 24, 37075, Göttingen, Germany sug: subj: Psychotropic Drugs Adverse Effects Accidental Falls Risk Factors Risk Assessment Germany Hospitalization of Older Persons Gerontologic Care Germany Human Inpatients Case Control Studies Germany Aged Aged, 80 and Over Age Factors Sex Factors Univariate Statistics Multivariate Analysis Odds Ratio Confidence Intervals Antianxiety Agents, Benzodiazepine Adverse Effects Serotonin Uptake Inhibitors Adverse Effects Norepinephrine Adverse Effects Antipsychotic Agents Adverse Effects Angiotensin-Converting Enzyme Inhibitors Adverse Effects Angiotensin II Type I Receptor Blockers Adverse Effects Digoxin Adverse Effects Aldosterone Antagonists Adverse Effects Hyponatremia Diagnosis Leukocyte Disorders Diagnosis Hematologic Tests Parkinson Disease Diagnosis Delirium Diagnosis Parkinson Disease Complications Delirium Complications Aged: 65+ years Aged, 80 & over ab: Objective: To examine the impact of medication and medical conditions on the fall risk in older hospitalized patients. Design: Matched case-control study. Setting: Large regional hospital in a mid-sized German city. Subjects: Four hundred eighty-one inpatients aged ≥ 65 years who fell during hospitalization ("cases") and a control group of 481 controls, matched for age, gender, and hospital department. Methods: Diagnosis, medication, vital parameters, and injuries were compared between cases and controls. Univariate and multivariable odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) were calculated. Main results: Several drugs were significantly associated with falls in multivariate analyses: long-acting benzodiazepines (adjusted OR = 3.49; 95%-CI = 1.16–10.52), serotonin-noradrenalin reuptake inhibitors (SNRI) (2.57; 1.23–5.12), Z-drugs (2.29; 1.38–3.59), low-potency neuroleptics (1.87; 1.08–3.23), ACE inhibitors/sartans (1.42; 1.07–1.89). Digoxin (0.32; 0.11–0.99) and aldosterone receptor antagonists (0.54; 0.33–0.88) were negatively associated with falls. No significant association in multivariate analyses was found for short- and intermediate-acting benzodiazepines, mirtazapine, and opioids. Hyponatremia (1.52; 1.15–2.03) and leukocytosis (1.39; 1.05–1.87) in blood examination on admission showed significant association with falls. As secondary diagnoses, Parkinson syndrome (2.38; 1.27–4.46) and delirium (3.74; 2.26–6.21) were strongly associated with falls. The use of more than one psychoactive drug was a separate risk factor for falls (p < 0.0001). Conclusion: Several drugs including SNRI, neuroleptics, and Z-drugs showed a significant association with inpatient falls. The frequently prescribed tetracyclic antidepressant mirtazapine did not appear to increase the risk of falls. Psychoactive polypharmacy should be avoided. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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