Injurious falls and subsequent adverse drug events among elderly - a Swedish population-based matched case-control study
Abstract Background Fall injuries are stressful and painful and they have a range of serious consequences for older people. While there is some clinical evidence of unintentional poisoning by medication following a severe fall injuries, population-based studies on that association are lacking. This...
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| Format: | Article |
| Language: | English |
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BMC
2017-09-01
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| Series: | BMC Geriatrics |
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| Online Access: | http://link.springer.com/article/10.1186/s12877-017-0594-1 |
| _version_ | 1818455125476245504 |
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| author | C. Rausch L. Laflamme S. E. de Rooij U. Bültmann J Möller |
| author_facet | C. Rausch L. Laflamme S. E. de Rooij U. Bültmann J Möller |
| author_sort | C. Rausch |
| collection | DOAJ |
| description | Abstract Background Fall injuries are stressful and painful and they have a range of serious consequences for older people. While there is some clinical evidence of unintentional poisoning by medication following a severe fall injuries, population-based studies on that association are lacking. This is investigated in the current study, in which attention is also paid to different clinical conditions of the injured patients. Methods We conducted a matched case-control study of Swedish residents 60 years and older from various Swedish population-based registers. Cases defined as adverse drug events (ADE) by unintentional poisoning leading to hospitalization or death were extracted from the National Patient Register (NPR) and the Cause of Death Register from January 2006 to December 2009 (n = 4418). To each case, four controls were matched by sex, age and residential area. Information on injurious falls leading to hospitalization six months prior to the date of hospital admission or death from ADE by unintentional poisoning, and corresponding date for the controls, was extracted from the NPR. Data on clinical conditions, such as dispensed medications, comorbidity and previous fall injuries were also extracted from the Swedish Prescribed Drug Register (SPDR) and NPR. Effect estimates were calculated using conditional logistic regression and presented as odds ratios (OR) and 95% confidence intervals (CI). Results We found a three-fold increased risk of unintentional poisoning by medication in the six-month period after an injurious fall (OR 3.03; 95% CI, 2.54–3.74), with the most pronounced increase 1–3 weeks immediately after (OR, 7.66; 95% CI, 4.86–12.1). In that time window, from among those hospitalized for a fall (n = 92), those who sustained an unintentional poisoning (n = 60) tended to be in poorer health condition and receive more prescribed medications than those who did not, although this was not statistically significant. Age stratified analyses revealed a higher risk of poisoning among the younger (aged 60–79 years) than older elderly (80+ years). Conclusion Medication-related poisoning leading to hospitalization or death can be an ADE subsequent to an episode of hospitalization for a fall-related injury. Poisoning is more likely to occur closer to the injurious event and among the younger elderly. It cannot be ruled out that some of those falls are themselves ADE and early signs of greater vulnerability among certain patients. |
| first_indexed | 2024-12-14T22:05:48Z |
| format | Article |
| id | doaj.art-ae7685de9a3b4ac3b9a51bdb741a5bda |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-12-14T22:05:48Z |
| publishDate | 2017-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-ae7685de9a3b4ac3b9a51bdb741a5bda2022-12-21T22:45:52ZengBMCBMC Geriatrics1471-23182017-09-011711810.1186/s12877-017-0594-1Injurious falls and subsequent adverse drug events among elderly - a Swedish population-based matched case-control studyC. Rausch0L. Laflamme1S. E. de Rooij2U. Bültmann3J Möller4Department of Public Health Sciences, Karolinska InstitutetDepartment of Public Health Sciences, Karolinska InstitutetDepartment of Internal Medicine, University Center for Geriatric Medicine, University of Groningen, University Medical Center GroningenDepartment of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center GroningenDepartment of Public Health Sciences, Karolinska InstitutetAbstract Background Fall injuries are stressful and painful and they have a range of serious consequences for older people. While there is some clinical evidence of unintentional poisoning by medication following a severe fall injuries, population-based studies on that association are lacking. This is investigated in the current study, in which attention is also paid to different clinical conditions of the injured patients. Methods We conducted a matched case-control study of Swedish residents 60 years and older from various Swedish population-based registers. Cases defined as adverse drug events (ADE) by unintentional poisoning leading to hospitalization or death were extracted from the National Patient Register (NPR) and the Cause of Death Register from January 2006 to December 2009 (n = 4418). To each case, four controls were matched by sex, age and residential area. Information on injurious falls leading to hospitalization six months prior to the date of hospital admission or death from ADE by unintentional poisoning, and corresponding date for the controls, was extracted from the NPR. Data on clinical conditions, such as dispensed medications, comorbidity and previous fall injuries were also extracted from the Swedish Prescribed Drug Register (SPDR) and NPR. Effect estimates were calculated using conditional logistic regression and presented as odds ratios (OR) and 95% confidence intervals (CI). Results We found a three-fold increased risk of unintentional poisoning by medication in the six-month period after an injurious fall (OR 3.03; 95% CI, 2.54–3.74), with the most pronounced increase 1–3 weeks immediately after (OR, 7.66; 95% CI, 4.86–12.1). In that time window, from among those hospitalized for a fall (n = 92), those who sustained an unintentional poisoning (n = 60) tended to be in poorer health condition and receive more prescribed medications than those who did not, although this was not statistically significant. Age stratified analyses revealed a higher risk of poisoning among the younger (aged 60–79 years) than older elderly (80+ years). Conclusion Medication-related poisoning leading to hospitalization or death can be an ADE subsequent to an episode of hospitalization for a fall-related injury. Poisoning is more likely to occur closer to the injurious event and among the younger elderly. It cannot be ruled out that some of those falls are themselves ADE and early signs of greater vulnerability among certain patients.http://link.springer.com/article/10.1186/s12877-017-0594-1adverse drug eventpoisoninginjurious fallsinappropriate drug use |
| spellingShingle | C. Rausch L. Laflamme S. E. de Rooij U. Bültmann J Möller Injurious falls and subsequent adverse drug events among elderly - a Swedish population-based matched case-control study BMC Geriatrics adverse drug event poisoning injurious falls inappropriate drug use |
| title | Injurious falls and subsequent adverse drug events among elderly - a Swedish population-based matched case-control study |
| title_full | Injurious falls and subsequent adverse drug events among elderly - a Swedish population-based matched case-control study |
| title_fullStr | Injurious falls and subsequent adverse drug events among elderly - a Swedish population-based matched case-control study |
| title_full_unstemmed | Injurious falls and subsequent adverse drug events among elderly - a Swedish population-based matched case-control study |
| title_short | Injurious falls and subsequent adverse drug events among elderly - a Swedish population-based matched case-control study |
| title_sort | injurious falls and subsequent adverse drug events among elderly a swedish population based matched case control study |
| topic | adverse drug event poisoning injurious falls inappropriate drug use |
| url | http://link.springer.com/article/10.1186/s12877-017-0594-1 |
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