Relationship between potentially inappropriate medications and functional prognosis in elderly patients with distal radius fracture: a retrospective cohort study

Abstract Background Potentially inappropriate medications (PIMs) are a major concern in geriatric care. PIMs increase the risk of falls in elderly patients. However, the relationship between PIMs, subsequent falls, and functional prognosis for distal radius fracture (DRF) remains unclear. The aim of...

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Main Authors: Takako Nagai, Masahiro Nagaoka, Koji Tanimoto, Yoshiaki Tomizuka, Hiroshi Uei, Kazuyoshi Nakanishi
Format: Article
Language:English
Published: BMC 2020-08-01
Series:Journal of Orthopaedic Surgery and Research
Subjects:
Online Access:http://link.springer.com/article/10.1186/s13018-020-01861-w
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spelling doaj-9b179191f5b84955b83ebda068a73f5e2020-11-25T03:20:39ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2020-08-011511810.1186/s13018-020-01861-wRelationship between potentially inappropriate medications and functional prognosis in elderly patients with distal radius fracture: a retrospective cohort studyTakako Nagai0Masahiro Nagaoka1Koji Tanimoto2Yoshiaki Tomizuka3Hiroshi Uei4Kazuyoshi Nakanishi5Department of Orthopedic Surgery, Nihon University HospitalDepartment of Orthopedic Surgery, Nihon University HospitalDepartment of Orthopedic Surgery, Nihon University HospitalDepartment of Orthopedic Surgery, Nihon University HospitalDepartment of Orthopedic Surgery, Nihon University HospitalDepartment of Orthopedic Surgery, Nihon University School of MedicineAbstract Background Potentially inappropriate medications (PIMs) are a major concern in geriatric care. PIMs increase the risk of falls in elderly patients. However, the relationship between PIMs, subsequent falls, and functional prognosis for distal radius fracture (DRF) remains unclear. The aim of this study was to examine the relationship between PIMs, activities of daily living, and subsequent falls in elderly DRF patients. Methods The study included 253 patients aged ≥ 65 years who required surgical treatment for DRF. Clinical characteristics of patients obtained included age, sex, body mass index, number of medicines used at admission, number and type of PIMs used at admission, bone mineral density, use of drugs for osteoporosis, severity of comorbidities, nutritional status, Barthel Index (BI), length of hospital stay, subsequent falls, fracture type, and Mayo wrist score. Subjects were divided into two groups according to PIMs use and no use. Propensity score matching was used to assess patient characteristics and confirm factors affecting BI and subsequent falls. Results One hundred seven patients (42.3%) were prescribed PIMs upon hospital admission. The mean BI gain was significantly lower in patients prescribed PIMs than in those who were not (p = 0.006), as was the rate of falls post-surgery (p = 0.009). Multivariate analysis of BI gain showed that PIMs affected BI gain (95% confidence interval [CI], − 1.589 to − 0.196, p = 0.012), and logistic regression analysis revealed that PIMs influenced subsequent falls (odds ratio, 0.108, 95% CI, 1.246 to 2.357, p < 0.001). Conclusions PIM use hindered the improvement in activities of daily living and increased the incidence of subsequent falls in patients assessed. These results demonstrate the importance of appropriate drug control for patients with DRF.http://link.springer.com/article/10.1186/s13018-020-01861-wDistal radius fractureFallsPotentially inappropriate medicationsSubsequent falls
collection DOAJ
language English
format Article
sources DOAJ
author Takako Nagai
Masahiro Nagaoka
Koji Tanimoto
Yoshiaki Tomizuka
Hiroshi Uei
Kazuyoshi Nakanishi
spellingShingle Takako Nagai
Masahiro Nagaoka
Koji Tanimoto
Yoshiaki Tomizuka
Hiroshi Uei
Kazuyoshi Nakanishi
Relationship between potentially inappropriate medications and functional prognosis in elderly patients with distal radius fracture: a retrospective cohort study
Journal of Orthopaedic Surgery and Research
Distal radius fracture
Falls
Potentially inappropriate medications
Subsequent falls
author_facet Takako Nagai
Masahiro Nagaoka
Koji Tanimoto
Yoshiaki Tomizuka
Hiroshi Uei
Kazuyoshi Nakanishi
author_sort Takako Nagai
title Relationship between potentially inappropriate medications and functional prognosis in elderly patients with distal radius fracture: a retrospective cohort study
title_short Relationship between potentially inappropriate medications and functional prognosis in elderly patients with distal radius fracture: a retrospective cohort study
title_full Relationship between potentially inappropriate medications and functional prognosis in elderly patients with distal radius fracture: a retrospective cohort study
title_fullStr Relationship between potentially inappropriate medications and functional prognosis in elderly patients with distal radius fracture: a retrospective cohort study
title_full_unstemmed Relationship between potentially inappropriate medications and functional prognosis in elderly patients with distal radius fracture: a retrospective cohort study
title_sort relationship between potentially inappropriate medications and functional prognosis in elderly patients with distal radius fracture: a retrospective cohort study
publisher BMC
series Journal of Orthopaedic Surgery and Research
issn 1749-799X
publishDate 2020-08-01
description Abstract Background Potentially inappropriate medications (PIMs) are a major concern in geriatric care. PIMs increase the risk of falls in elderly patients. However, the relationship between PIMs, subsequent falls, and functional prognosis for distal radius fracture (DRF) remains unclear. The aim of this study was to examine the relationship between PIMs, activities of daily living, and subsequent falls in elderly DRF patients. Methods The study included 253 patients aged ≥ 65 years who required surgical treatment for DRF. Clinical characteristics of patients obtained included age, sex, body mass index, number of medicines used at admission, number and type of PIMs used at admission, bone mineral density, use of drugs for osteoporosis, severity of comorbidities, nutritional status, Barthel Index (BI), length of hospital stay, subsequent falls, fracture type, and Mayo wrist score. Subjects were divided into two groups according to PIMs use and no use. Propensity score matching was used to assess patient characteristics and confirm factors affecting BI and subsequent falls. Results One hundred seven patients (42.3%) were prescribed PIMs upon hospital admission. The mean BI gain was significantly lower in patients prescribed PIMs than in those who were not (p = 0.006), as was the rate of falls post-surgery (p = 0.009). Multivariate analysis of BI gain showed that PIMs affected BI gain (95% confidence interval [CI], − 1.589 to − 0.196, p = 0.012), and logistic regression analysis revealed that PIMs influenced subsequent falls (odds ratio, 0.108, 95% CI, 1.246 to 2.357, p < 0.001). Conclusions PIM use hindered the improvement in activities of daily living and increased the incidence of subsequent falls in patients assessed. These results demonstrate the importance of appropriate drug control for patients with DRF.
topic Distal radius fracture
Falls
Potentially inappropriate medications
Subsequent falls
url http://link.springer.com/article/10.1186/s13018-020-01861-w
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