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Inappropriate drug use in elderly patients is associated with prolonged hospital stay and increased postoperative mortality after colorectal cancer surgery: a population-based study
Aim The study aimed to investigate whether continuing potentially inappropriate medication (PIM) is associated with length of hospital stay (LOS) and postoperative mortality in elderly people undergoing colorectal cancer surgery. Method The Swedish National Colorectal Cancer Register and the Swedish...
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| Published in: | Colorectal disease 2016-02, Vol.18 (2), p.155-162 |
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| cites | cdi_FETCH-LOGICAL-c5197-8f5459c5bf11174d2a897113530493921cc16709b775c843e671e824b98c36933 |
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| container_issue | 2 |
| container_start_page | 155 |
| container_title | Colorectal disease |
| container_volume | 18 |
| creator | Samuelsson, K. S. Egenvall, M. Klarin, I. Lökk, J. Gunnarsson, U. |
| description | Aim
The study aimed to investigate whether continuing potentially inappropriate medication (PIM) is associated with length of hospital stay (LOS) and postoperative mortality in elderly people undergoing colorectal cancer surgery.
Method
The Swedish National Colorectal Cancer Register and the Swedish Prescribed Drug Register provided matched data on 7279 patients aged 75 years or more who had undergone bowel resection for colorectal cancer between 2007 and 2010. Patients were divided into two groups depending on whether or not they were taking PIM at the time of surgery. The primary efficacy variables were the LOS and 30‐day postoperative mortality.
Results
Of the 7279 patients, 22.5% (1641) of the patients were exposed to at least one PIM and the total number of drugs taken in this group was six, compared with three in the non‐PIM group (P |
| doi_str_mv | 10.1111/codi.13077 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_swepu</sourceid><recordid>TN_cdi_swepub_primary_oai_swepub_ki_se_511575</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1762344943</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5197-8f5459c5bf11174d2a897113530493921cc16709b775c843e671e824b98c36933</originalsourceid><addsrcrecordid>eNp9ks1u1DAURiMEoqWw4QGQlwgpJY7tOGZXTaEdaURZDLC0PM6dqWkmDrbDkAfj_bjzy4pmE9s534n86WbZa1pcUnzeW9-4S8oKKZ9k55RXLKeM1k936zKvFS3Oshcx_igKWklaP8_Oyqrkpaj4efZn2pm-D74PziQgTRhWZIhAXEegbSC0I-lNctClSFwkJkZvt2RDNi7dE0y2vlvh9t7H3iXTkpjMSEzXoMIGMBG_9T4m30NA0S8gax-QcwmpZYJALCoC2G3Wms7iSRzCCsL4gRiM9kOLOd_li50rpqEZX2bPlqaN8Orwvsi-fvo4n9zms7ub6eRqlltBlczrpeBCWbFYYk2SN6WplaSUCVZwxVRJrcVGCrWQUtiaM8B6oC75QtWWVYqxiyzfe-MG-mGhsaW1CaP2xunD0QOuQAtKhRTIq__yWFXzL3QMUlbWquRCPPqva_ftSvuw0sN60HgVpjjyb_c8in8OEJNeu2ihbU0HfoiayqpknCOJ6Ls9aoOPMcDyJKeF3o6Q3o6Q3o0Qwm8O3mGxhuaEHmcGAboHNq6F8RGVntxdT4_Sw-VcTPD7lDHhQVeSSaG_f77RdD6b35ZfhJ6wv7MJ5dA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1762344943</pqid></control><display><type>article</type><title>Inappropriate drug use in elderly patients is associated with prolonged hospital stay and increased postoperative mortality after colorectal cancer surgery: a population-based study</title><source>Wiley-Blackwell Read & Publish Collection</source><creator>Samuelsson, K. S. ; Egenvall, M. ; Klarin, I. ; Lökk, J. ; Gunnarsson, U.</creator><creatorcontrib>Samuelsson, K. S. ; Egenvall, M. ; Klarin, I. ; Lökk, J. ; Gunnarsson, U.</creatorcontrib><description>Aim
The study aimed to investigate whether continuing potentially inappropriate medication (PIM) is associated with length of hospital stay (LOS) and postoperative mortality in elderly people undergoing colorectal cancer surgery.
Method
The Swedish National Colorectal Cancer Register and the Swedish Prescribed Drug Register provided matched data on 7279 patients aged 75 years or more who had undergone bowel resection for colorectal cancer between 2007 and 2010. Patients were divided into two groups depending on whether or not they were taking PIM at the time of surgery. The primary efficacy variables were the LOS and 30‐day postoperative mortality.
Results
Of the 7279 patients, 22.5% (1641) of the patients were exposed to at least one PIM and the total number of drugs taken in this group was six, compared with three in the non‐PIM group (P < 0.001). Postoperative mortality was higher in the PIM group (7.1% vs 4.5%, P < 0.001), and LOS was longer (10 days vs 9, P = 0.001). When adjusted for independent predictors, the differences in LOS (odds ratio 1.14; 95% confidence interval 1.00–1.29, P = 0.046) and postoperative mortality (odds ratio 1.43; 95% confidence interval 1.11–1.85, P = 0.006) remained significant.
Conclusion
The use of PIM prior to surgery is associated with increased postoperative mortality and prolonged hospital stay. Although no causal relationship is proved, the results add a further aspect to preoperative optimization of elderly patients about to have major colorectal surgery.</description><identifier>ISSN: 1462-8910</identifier><identifier>ISSN: 1463-1318</identifier><identifier>EISSN: 1463-1318</identifier><identifier>DOI: 10.1111/codi.13077</identifier><identifier>PMID: 26242564</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Aged ; Aged, 80 and over ; Colectomy - mortality ; colorectal cancer surgery ; Colorectal Neoplasms - drug therapy ; Colorectal Neoplasms - mortality ; Colorectal Neoplasms - surgery ; elderly ; Female ; Humans ; Inappropriate Prescribing - adverse effects ; length hospital stay ; length of hospital stay ; Length of Stay - statistics & numerical data ; Male ; Medicin och hälsovetenskap ; Odds Ratio ; postoperative mortality ; Postoperative Period ; Potentially inappropriate drug use ; Potentially Inappropriate Medication List - statistics & numerical data ; Preoperative Period ; Prospective Studies ; Registries ; Risk Factors ; Sweden - epidemiology</subject><ispartof>Colorectal disease, 2016-02, Vol.18 (2), p.155-162</ispartof><rights>Colorectal Disease © 2015 The Association of Coloproctology of Great Britain and Ireland</rights><rights>Colorectal Disease © 2015 The Association of Coloproctology of Great Britain and Ireland.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5197-8f5459c5bf11174d2a897113530493921cc16709b775c843e671e824b98c36933</citedby><cites>FETCH-LOGICAL-c5197-8f5459c5bf11174d2a897113530493921cc16709b775c843e671e824b98c36933</cites><orcidid>0000-0002-3251-9363</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26242564$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-117394$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:132892455$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Samuelsson, K. S.</creatorcontrib><creatorcontrib>Egenvall, M.</creatorcontrib><creatorcontrib>Klarin, I.</creatorcontrib><creatorcontrib>Lökk, J.</creatorcontrib><creatorcontrib>Gunnarsson, U.</creatorcontrib><title>Inappropriate drug use in elderly patients is associated with prolonged hospital stay and increased postoperative mortality after colorectal cancer surgery: a population-based study</title><title>Colorectal disease</title><addtitle>Colorectal Dis</addtitle><description>Aim
The study aimed to investigate whether continuing potentially inappropriate medication (PIM) is associated with length of hospital stay (LOS) and postoperative mortality in elderly people undergoing colorectal cancer surgery.
Method
The Swedish National Colorectal Cancer Register and the Swedish Prescribed Drug Register provided matched data on 7279 patients aged 75 years or more who had undergone bowel resection for colorectal cancer between 2007 and 2010. Patients were divided into two groups depending on whether or not they were taking PIM at the time of surgery. The primary efficacy variables were the LOS and 30‐day postoperative mortality.
Results
Of the 7279 patients, 22.5% (1641) of the patients were exposed to at least one PIM and the total number of drugs taken in this group was six, compared with three in the non‐PIM group (P < 0.001). Postoperative mortality was higher in the PIM group (7.1% vs 4.5%, P < 0.001), and LOS was longer (10 days vs 9, P = 0.001). When adjusted for independent predictors, the differences in LOS (odds ratio 1.14; 95% confidence interval 1.00–1.29, P = 0.046) and postoperative mortality (odds ratio 1.43; 95% confidence interval 1.11–1.85, P = 0.006) remained significant.
Conclusion
The use of PIM prior to surgery is associated with increased postoperative mortality and prolonged hospital stay. Although no causal relationship is proved, the results add a further aspect to preoperative optimization of elderly patients about to have major colorectal surgery.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Colectomy - mortality</subject><subject>colorectal cancer surgery</subject><subject>Colorectal Neoplasms - drug therapy</subject><subject>Colorectal Neoplasms - mortality</subject><subject>Colorectal Neoplasms - surgery</subject><subject>elderly</subject><subject>Female</subject><subject>Humans</subject><subject>Inappropriate Prescribing - adverse effects</subject><subject>length hospital stay</subject><subject>length of hospital stay</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Male</subject><subject>Medicin och hälsovetenskap</subject><subject>Odds Ratio</subject><subject>postoperative mortality</subject><subject>Postoperative Period</subject><subject>Potentially inappropriate drug use</subject><subject>Potentially Inappropriate Medication List - statistics & numerical data</subject><subject>Preoperative Period</subject><subject>Prospective Studies</subject><subject>Registries</subject><subject>Risk Factors</subject><subject>Sweden - epidemiology</subject><issn>1462-8910</issn><issn>1463-1318</issn><issn>1463-1318</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><recordid>eNp9ks1u1DAURiMEoqWw4QGQlwgpJY7tOGZXTaEdaURZDLC0PM6dqWkmDrbDkAfj_bjzy4pmE9s534n86WbZa1pcUnzeW9-4S8oKKZ9k55RXLKeM1k936zKvFS3Oshcx_igKWklaP8_Oyqrkpaj4efZn2pm-D74PziQgTRhWZIhAXEegbSC0I-lNctClSFwkJkZvt2RDNi7dE0y2vlvh9t7H3iXTkpjMSEzXoMIGMBG_9T4m30NA0S8gax-QcwmpZYJALCoC2G3Wms7iSRzCCsL4gRiM9kOLOd_li50rpqEZX2bPlqaN8Orwvsi-fvo4n9zms7ub6eRqlltBlczrpeBCWbFYYk2SN6WplaSUCVZwxVRJrcVGCrWQUtiaM8B6oC75QtWWVYqxiyzfe-MG-mGhsaW1CaP2xunD0QOuQAtKhRTIq__yWFXzL3QMUlbWquRCPPqva_ftSvuw0sN60HgVpjjyb_c8in8OEJNeu2ihbU0HfoiayqpknCOJ6Ls9aoOPMcDyJKeF3o6Q3o6Q3o0Qwm8O3mGxhuaEHmcGAboHNq6F8RGVntxdT4_Sw-VcTPD7lDHhQVeSSaG_f77RdD6b35ZfhJ6wv7MJ5dA</recordid><startdate>201602</startdate><enddate>201602</enddate><creator>Samuelsson, K. S.</creator><creator>Egenvall, M.</creator><creator>Klarin, I.</creator><creator>Lökk, J.</creator><creator>Gunnarsson, U.</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D93</scope><orcidid>https://orcid.org/0000-0002-3251-9363</orcidid></search><sort><creationdate>201602</creationdate><title>Inappropriate drug use in elderly patients is associated with prolonged hospital stay and increased postoperative mortality after colorectal cancer surgery: a population-based study</title><author>Samuelsson, K. S. ; Egenvall, M. ; Klarin, I. ; Lökk, J. ; Gunnarsson, U.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5197-8f5459c5bf11174d2a897113530493921cc16709b775c843e671e824b98c36933</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Colectomy - mortality</topic><topic>colorectal cancer surgery</topic><topic>Colorectal Neoplasms - drug therapy</topic><topic>Colorectal Neoplasms - mortality</topic><topic>Colorectal Neoplasms - surgery</topic><topic>elderly</topic><topic>Female</topic><topic>Humans</topic><topic>Inappropriate Prescribing - adverse effects</topic><topic>length hospital stay</topic><topic>length of hospital stay</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Male</topic><topic>Medicin och hälsovetenskap</topic><topic>Odds Ratio</topic><topic>postoperative mortality</topic><topic>Postoperative Period</topic><topic>Potentially inappropriate drug use</topic><topic>Potentially Inappropriate Medication List - statistics & numerical data</topic><topic>Preoperative Period</topic><topic>Prospective Studies</topic><topic>Registries</topic><topic>Risk Factors</topic><topic>Sweden - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Samuelsson, K. S.</creatorcontrib><creatorcontrib>Egenvall, M.</creatorcontrib><creatorcontrib>Klarin, I.</creatorcontrib><creatorcontrib>Lökk, J.</creatorcontrib><creatorcontrib>Gunnarsson, U.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Umeå universitet</collection><jtitle>Colorectal disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Samuelsson, K. S.</au><au>Egenvall, M.</au><au>Klarin, I.</au><au>Lökk, J.</au><au>Gunnarsson, U.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Inappropriate drug use in elderly patients is associated with prolonged hospital stay and increased postoperative mortality after colorectal cancer surgery: a population-based study</atitle><jtitle>Colorectal disease</jtitle><addtitle>Colorectal Dis</addtitle><date>2016-02</date><risdate>2016</risdate><volume>18</volume><issue>2</issue><spage>155</spage><epage>162</epage><pages>155-162</pages><issn>1462-8910</issn><issn>1463-1318</issn><eissn>1463-1318</eissn><abstract>Aim
The study aimed to investigate whether continuing potentially inappropriate medication (PIM) is associated with length of hospital stay (LOS) and postoperative mortality in elderly people undergoing colorectal cancer surgery.
Method
The Swedish National Colorectal Cancer Register and the Swedish Prescribed Drug Register provided matched data on 7279 patients aged 75 years or more who had undergone bowel resection for colorectal cancer between 2007 and 2010. Patients were divided into two groups depending on whether or not they were taking PIM at the time of surgery. The primary efficacy variables were the LOS and 30‐day postoperative mortality.
Results
Of the 7279 patients, 22.5% (1641) of the patients were exposed to at least one PIM and the total number of drugs taken in this group was six, compared with three in the non‐PIM group (P < 0.001). Postoperative mortality was higher in the PIM group (7.1% vs 4.5%, P < 0.001), and LOS was longer (10 days vs 9, P = 0.001). When adjusted for independent predictors, the differences in LOS (odds ratio 1.14; 95% confidence interval 1.00–1.29, P = 0.046) and postoperative mortality (odds ratio 1.43; 95% confidence interval 1.11–1.85, P = 0.006) remained significant.
Conclusion
The use of PIM prior to surgery is associated with increased postoperative mortality and prolonged hospital stay. Although no causal relationship is proved, the results add a further aspect to preoperative optimization of elderly patients about to have major colorectal surgery.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>26242564</pmid><doi>10.1111/codi.13077</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-3251-9363</orcidid></addata></record> |
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| identifier | ISSN: 1462-8910 |
| ispartof | Colorectal disease, 2016-02, Vol.18 (2), p.155-162 |
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| language | eng |
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| source | Wiley-Blackwell Read & Publish Collection |
| subjects | Aged Aged, 80 and over Colectomy - mortality colorectal cancer surgery Colorectal Neoplasms - drug therapy Colorectal Neoplasms - mortality Colorectal Neoplasms - surgery elderly Female Humans Inappropriate Prescribing - adverse effects length hospital stay length of hospital stay Length of Stay - statistics & numerical data Male Medicin och hälsovetenskap Odds Ratio postoperative mortality Postoperative Period Potentially inappropriate drug use Potentially Inappropriate Medication List - statistics & numerical data Preoperative Period Prospective Studies Registries Risk Factors Sweden - epidemiology |
| title | Inappropriate drug use in elderly patients is associated with prolonged hospital stay and increased postoperative mortality after colorectal cancer surgery: a population-based study |
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