Sex Differences in Multimorbidity, Inappropriate Medication and Adverse Outcomes of Inpatient Care: MoPIM Cohort Study.
Marisa BaréMarina LlealDaniel Sevilla-SanchezSara OrtonobesSusana HerranzOlivia FerrandezCelia Corral-VázquezNuria Molist-BrunetGloria Julia NazcoCandelaria Martín-GonzálezMiguel Ángel Márqueznull On Behalf Of The MoPIM Study GroupPublished in: International journal of environmental research and public health (2023)
There is no published evidence on the possible differences in multimorbidity, inappropriate prescribing, and adverse outcomes of care, simultaneously, from a sex perspective in older patients. We aimed to identify those possible differences in patients hospitalized because of a chronic disease exacerbation. A multicenter, prospective cohort study of 740 older hospitalized patients (≥65 years) was designed, registering sociodemographic variables, frailty, Barthel index, chronic conditions (CCs), geriatric syndromes (GSs), polypharmacy, potentially inappropriate prescribing (PIP) according to STOPP/START criteria, and adverse drug reactions (ADRs). Outcomes were length of stay (LOS), discharge to nursing home, in-hospital mortality, cause of mortality, and existence of any ADR and its worst consequence. Bivariate analyses between sex and all variables were performed, and a network graph was created for each sex using CC and GS. A total of 740 patients were included (53.2% females, 53.5% ≥85 years old). Women presented higher prevalence of frailty, and more were living in a nursing home or alone, and had a higher percentage of PIP related to anxiolytics or pain management drugs. Moreover, they presented significant pairwise associations between CC, such as asthma, vertigo, thyroid diseases, osteoarticular diseases, and sleep disorders, and with GS, such as chronic pain, constipation, and anxiety/depression. No significant differences in immediate adverse outcomes of care were observed between men and women in the exacerbation episode.
Keyphrases
- adverse drug
- pain management
- chronic pain
- end stage renal disease
- healthcare
- palliative care
- chronic obstructive pulmonary disease
- chronic kidney disease
- newly diagnosed
- primary care
- ejection fraction
- peritoneal dialysis
- physical activity
- quality improvement
- risk factors
- emergency department
- prognostic factors
- community dwelling
- sleep quality
- systematic review
- cardiovascular disease
- metabolic syndrome
- mental health
- pregnant women
- affordable care act
- machine learning
- patient reported outcomes
- drug induced
- patient reported
- cross sectional
- lung function
- convolutional neural network
- middle aged
- air pollution
- double blind
- irritable bowel syndrome