Exposure to medicines among patients admitted for hip fracture and the case-fatality rate at 1 year: a longitudinal study

Purpose To describe the demographic and clinical characteristics and the pre-fracture exposure to medicines of patients admitted for a hip fracture, and to explore their association with fatal outcome 1 year after the fracture. Methods All patients ≥65 years old admitted for a hip fracture in a tert...

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Bibliographic Details
Published in:European journal of clinical pharmacology 2012-11, Vol.68 (11), p.1525-1531
Main Authors: Agustí, A., Pagès, E., Cuxart, A., Ballarín, E., Vidal, X., Teixidor, J., Tomás, J., Villar, M. M., Laporte, J.-R.
Format: Article
Language:English
Subjects:
Age
Aged
Aged, 80 and over
Aging
Analgesics, Opioid - adverse effects
Analgesics, Opioid - therapeutic use
Biological and medical sciences
Biomedical and Life Sciences
Biomedicine
Bone Density Conservation Agents - adverse effects
Bone Density Conservation Agents - therapeutic use
Cancer
Cognition Disorders - complications
Cognition Disorders - physiopathology
Cognitive ability
Data processing
Demography
Diseases of the osteoarticular system
Drugs
Female
Fractures
Hip
Hip Fractures - complications
Hip Fractures - physiopathology
Hip Fractures - rehabilitation
Hip Fractures - therapy
Hip joint
Home Care Services
Hospital Mortality
Hospitals
Hospitals, Urban
Humans
Longitudinal Studies
Male
Medical sciences
Mortality
Opiates
Osteoporosis
Osteoporosis - drug therapy
Osteoporosis - physiopathology
Osteoporosis. Osteomalacia. Paget disease
Osteoporotic Fractures - complications
Osteoporotic Fractures - physiopathology
Osteoporotic Fractures - rehabilitation
Osteoporotic Fractures - therapy
Pain - drug therapy
Pain - etiology
Pain - prevention & control
Pharmacoepidemiology and Prescription
Pharmacology
Pharmacology. Drug treatments
Pharmacology/Toxicology
Severity of Illness Index
Sex Characteristics
Spain - epidemiology
Statistical analysis
Survival Analysis
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Summary:Purpose To describe the demographic and clinical characteristics and the pre-fracture exposure to medicines of patients admitted for a hip fracture, and to explore their association with fatal outcome 1 year after the fracture. Methods All patients ≥65 years old admitted for a hip fracture in a tertiary hospital in Barcelona between January 1 and December 31 2007 were included. Data on the patients’ clinical characteristics before and during hospital admission and on pre-fracture exposures to medicines were collected from the clinical records. One-year mortality was checked by approaching the patients and their families and was cross-checked with the national mortality statistics database. A Cox proportional hazards analysis was carried out. Results Four hundred and fifty-six patients [mean age (SD) 82.9 (7.2) years, 73.5 % female], were admitted with hip fracture during the study period. Almost 80 % of the patients (363, 79.6 %) had three or more associated conditions, and 41.7 % received pre-fracture treatment with five or more drugs. The case-fatality rate during hospital admission was 4.6 % (21 patients). One hundred and seven patients died within 1 year (23.5 %). Advanced age, male gender, two or more associated chronic conditions, cancer, severe cognitive impairment, and treatment with opiates before fracture were significantly associated with the risk of dying. An inverse association was recorded between mortality and pre-hospital exposure to medicines for osteoporosis. Conclusions One-quarter of patients admitted for hip fracture died within 1 year after the fracture. Exposure to opiates before hip fracture was associated with an increased 1-year death rate, whereas treatment with drugs for osteoporosis was associated with a decrease in death rate. These results should be confirmed in studies with detailed prospective collection of information on exposure to medicines.
ISSN:0031-6970
1432-1041
DOI:10.1007/s00228-012-1273-y