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Comparative Study
. 2011 Nov;59(11):2139-44.
doi: 10.1111/j.1532-5415.2011.03567.x. Epub 2011 Aug 30.

Inappropriate medication use in older adults undergoing surgery: a national study

Emily Finlayson  1 , Judith Maselli, Michael A Steinman, Michael B Rothberg, Peter K Lindenauer, Andrew D Auerbach
Affiliations
Comparative Study

Inappropriate medication use in older adults undergoing surgery: a national study

Emily Finlayson et al. J Am Geriatr Soc. 2011 Nov.

Abstract

Objectives: To determine the prevalence and factors associated with use of potentially inappropriate medications (PIMs) in older adults undergoing surgery.

Design: Retrospective cohort study.

Setting: Three hundred seventy-nine acute care hospitals participating in the nationally representative Perspective database (2006-2008).

Participants: Individuals aged 65 and older undergoing major inpatient gastrointestinal, gynecological, urological, and orthopedic surgery (N=272,351).

Measurements: Medications were classified as PIMs using previously published criteria defining 33 medications deemed potentially inappropriate in people aged 65 and older. Information about participant and provider characteristics and administration of PIMs was obtained from hospital discharge file data. Logistic regression techniques were used to examine factors associated with use of PIMs in the perioperative period.

Results: One-quarter of participants received at least one PIM during their surgical admission. Meperidine was the most frequently prescribed PIM (37,855, 14% of participants). In adjusted analysis, PIM use was less likely as age advanced (adjusted odds ratio (AOR)=0.98 per year of age, 95% confidence interval (CI)=0.97-0.98) and in men (AOR=0.83, 95% CI=0.81-0.85). PIMs were more likely to be prescribed to participants cared for by orthopedic surgeons than for those cared for by general surgeons (AOR=1.22, 95% CI=1.08-1.40). Participants undergoing surgery in the West (AOR=1.79, 95% CI=1.02-3.16) and South (AOR=2.24, 95% CI=1.38-3.64) were more likely to receive a PIM than those in the Northeast.

Conclusion: Receipt of PIMs in older adults undergoing surgery is common and varies widely between providers and geographic regions and according to participant characteristics. Interventions aimed at reducing the use of PIMs in the perioperative period should be considered in quality improvement efforts.

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Figures

Figure 1
Figure 1
Distribution of PIM and Meperidine Prescribing Rates Among Hospitals Treating > 50 Surgical Patients.
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References

    1. Etzioni DA, Liu JH, Maggard MA, et al. The aging population and its impact on the surgery workforce. Ann Surg. 2003;238:170–7. - PMC - PubMed
    1. Finlayson E, Fan Z, Birkmeyer JD. Outcomes in octogenarians undergoing high-risk cancer operation: A national study. J Am Coll Surg. 2007;205:729–34. - PubMed
    1. Schlosser FJV, Vaartjes I, van der Heijen GJMG, et al. Mortality after Elective Abdominal Aortic Aneurysm Repair. Ann Surg. 2010;251:158–64. - PubMed
    1. Massarweh NN, Legner VJ, Symons RG, et al. Impact of Advancing Age on Abdominal Surgical Outcomes. Arch Surg. 2009;144:1108–14. - PubMed
    1. McGory ML, Kao KK, Shekelle PG, et al. Developing Quality Indicators for Elderly Surgical Patients. Ann Surg. 2009;250:338–47. - PubMed

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