Key result
High-risk perioperative medication exposure affects ~76% of elderly surgical patients, peaking at age 70+.
Why the study?
Inappropriate perioperative medications among elderly patients increase adverse events and worsen surgical outcomes, motivating an evaluation of high-risk medication prevalence and verification of a newly developed high-risk perioperative medications list.
What is the prevalence of high-risk perioperative medications among elderly surgical patients, and what factors are associated with their use?
Cross-Sectional (n=810)
No
What is the prevalence of high-risk perioperative medications among elderly surgical patients, and what factors are associated with their use?
High-risk perioperative medications are highly prevalent (76.3%) among elderly surgical patients, particularly those who are older, have multiple comorbidities, or experience prolonged hospitalizations.
Warrants screening for high-risk perioperative medications in elderly surgical patients; leaves open whether reducing exposure improves outcomes.
BACKGROUND: Inappropriate perioperative medications among elderly patients increase the risk of adverse events and undermine surgical outcomes. This study aimed to assess the prevalence of high-risk medications in elderly surgical patients and verify the effectiveness of a new-developed high-risk perioperative medications (HRPOMs) list for the elderly. METHODS: A cross-sectional, single-center study was conducted at Jinshan Hospital of Fudan University. A total of 810 elderly surgical patients were included in the study. The HRPOMs list was applied to patients' data to identify the HRPOMs including chronic medications and medications related to surgery. RESULTS: A total of 2113 HRPOMs were identified in 810 patients who fulfilled the inclusion criteria. Of these, 1067 (50.5%) involved medications related to surgery, and 982 (46.5%) involved chronic medications. The prevalence of HRPOM exposure, which was defined as at least one HRPOM was 76.3%. Patients that were 70 years or older (adjusted odds ratio [AOR] =2.118, 95% confidence interval [CI], 1.420~3.159), hospitalized over two weeks (AOR =4.192, 95% CI, 1.493~11.771), with more than 2 distinct diagnoses (AOR =3.407, 95% CI, 2.224~5.220) and with 16 or more medications during hospitalization were more likely to be exposed to HRPOMs. Patients who underwent surgeries of Grade IV were at 1.73 increased odds of HRPOM exposure compared with those who received surgeries of Grade III or lower (P=0.071). CONCLUSION: HRPOMs are more common in patients of 70 years or older, with 3 or more distinct diagnoses, with 16 or more medications and hospitalized for 15 days or longer. Our study showed the validity of the HRPOMs list in the perioperative medication review for the elderly and may induce further research to reveal the impact of HRPOMs upon the surgical outcomes of the elderly.
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Wang et al. (2021) conducted a cross-sectional in Elderly surgical patients (n=810). High-risk perioperative medications (HRPOMs) was evaluated on Prevalence of at least one high-risk perioperative medication (HRPOM) exposure. In a cross-sectional study of 810 elderly surgical patients in China, the prevalence of exposure to at least one high-risk perioperative medication was 76.3%, with significantly higher risk in patients aged 70 years or older.
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